[PP-140]
Serum procalcitonin levels in prostate cancer: A new biomarker?
Lütfi Canat, Osman Can, Muammer Bozkurt, Hasan Anıl Atalay, İlter Alkan, Fatih Altunrende, Alper ÖtünçtemurThe aim of the prospective study was to examine the role of serum procalcitonin (PCT) as a biomarker for the detection of prostate cancer (Pca) in patients with a serum prostate specific antigen (PSA) 2 - 20.0 ng/ml. The patients with acute prostatitis, any clinical or laboratory signs of systemic or urinary tract infection, history of inflammatory disease which may affect the PCT values were excluded from the study. We also excluded the patients who had previously been taking an androgen blocker, 5 alpha-reductase inhibitor, anti-inflammatory, or systemic steroid treatment. All patients were divided into three groups: Total PSA level between 2-4 ng/ml, 4.1-10 ng/ml, and 10.1-20 ng/ml. Serum PCT levels were measured 3 days before biopsy. Biopsy protocol consisted of 12 core sextant biopsies of the peripheral zone and pathological sample results were categorized as ‘benign’ or ‘prostate adenocarcinoma’. The clinical and pathological features of the 227 patients are summarized in the Table. On transrectal biopsy, 153 (67.4%) men were found to have benign pathology and 74 (32.6%) men were found to have Pca all of which had clinical stage T1cN0M0. Age and total PSA values were similar between the benign and cancer groups, and PSA density tended to be higher in the cancer group compared with the benign group (0.31 ± 0.23 vs. 0.19 ± 0.11; p=0.001). The difference in mean serum PCT values was significantly higher in the cancer group compared with the benign group (0.06 ± 0.03 ng/ml vs. 0.04 ± 0.03 ng/ml p=0.0001). Serum PCT levels was not able to differentiate between prostate cancer patients with PSA level of 2-4 ng/ml, 4.1-10 ng/ml, 10.1-20 ng/ml. Using a threshold of 0.045 ng/ml, PCT was 54.1% sensitive and 80.3% specific for prostate cancer patients with a serum PSA level of 2-20 ng/ml (AUC 0.683) (Figure). In conclusion, the evaluation of serum PCT can be utilized as a new and simple method for screening and diagnosis of Pca. Even if our results can be regarded as preliminary, elevated PCT level may play a role as a biomarker in detecting Pca for patients with PSA 2 – 20 ng/ml.
Figure
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Receiver-operating characteristic (ROC) curves of serum PCT for discrimination between presence of prostate cancer and absence of malignancy.
Clinical, laboratory, and pathological features in patients with and without prostatecancer.
| Benign biopsy (n=153) | Prostate cancer (n=74) | p | |
| Age (yr) | 64.1 ± 6.8 | 66.4 ± 9.9 | 0.067 |
| PSA (ng/ml) | 8.1 ±4.1 | 10.3 ± 6.3 | 0.075 |
| PSA 2-4 ng/ml, n (%) | 11 (7.2) | 8 (10.8) | |
| PSA 4.1-10 ng/ml, n (%) | 101 (66.4) | 37 (50) | |
| PSA 10.1-20 ng/ml, n (%) | 40 (26.3) | 29 (39.2) | |
| PSA density (ng/ml/ml) | 0.19 ± 0.11 | 0.31 ± 0.23 | 0.001 |
| Procalcitonin (ng/ml) | 0.04 ± 0.03 | 0.06 ± 0.03 | 0.0001 |
| Gleason score, n(%) <7 | 27 (36.4) | ||
| Gleason score, n(%) 7 (3+4) | 20 (27.1) | ||
| Gleason score, n(%) 7 (4+3) | 14 (18.9) | ||
| Gleason score, n(%) >7 | 13 (17.56) |
PSA, prostate specific antigen