Usefulness of LacdiNAc-glycosylated Prostate-specific Antigen Density for Predicting Pathological Findings of Magnetic Resonance Imaging-transrectal Ultrasound Fusion Image-guided Prostate Biopsy for the Patients With Highest Prostate Imaging Reporting and Data System Category ≥3

Sunao Shoji; Takatoshi Kaya; Yumiko Tanaka; Kohei Uemura; Taku Kusaka; Kumpei Takahashi; Soichiro Yuzuriha; Tatsuo Kano; Izumi Hanada; Tatsuya Umemoto; Takahiro Ogawa; Mayura Nakano; Masayoshi Kawakami; Masahiro Nitta; Masanori Hasegawa; Kazunobu Hashida; Terumitsu Hasebe; Tomonori Kaneko; Jun Okada; Satomi Asai; Akira Miyajima

doi:10.1097/JU.0000000000002958

Usefulness of LacdiNAc-glycosylated Prostate-specific Antigen Density for Predicting Pathological Findings of Magnetic Resonance Imaging-transrectal Ultrasound Fusion Image-guided Prostate Biopsy for the Patients With Highest Prostate Imaging Reporting and Data System Category ≥3

J Urol. 2023 Jan;209(1):187-197. doi: 10.1097/JU.0000000000002958. Epub 2022 Sep 6.

Authors

Sunao Shoji¹, Takatoshi Kaya², Yumiko Tanaka³, Kohei Uemura⁴, Taku Kusaka³, Kumpei Takahashi¹, Soichiro Yuzuriha¹, Tatsuo Kano¹, Izumi Hanada¹, Tatsuya Umemoto¹, Takahiro Ogawa¹, Mayura Nakano¹, Masayoshi Kawakami¹, Masahiro Nitta¹, Masanori Hasegawa¹, Kazunobu Hashida⁵, Terumitsu Hasebe⁵, Tomonori Kaneko², Jun Okada², Satomi Asai⁶, Akira Miyajima¹

Affiliations

¹ Department of Urology, Tokai University School of Medicine, Kanagawa, Japan.
² Precision Medicine Business Unit, Healthcare Business Headquarters, Konica Minolta, Inc., Tokyo, Japan.
³ Department of Clinical Laboratory, Tokai University Hospital, Kanagawa, Japan.
⁴ Biostatistics and Bioinformatics Course, The University of Tokyo, Tokyo, Japan.
⁵ Department of Radiology, Tokai University Hachioji Hospital, Tokyo, Japan.
⁶ Department of Laboratory Medicine, Tokai University School of Medicine, Kanagawa, Japan.

PMID: 36067387
DOI: 10.1097/JU.0000000000002958

Abstract

Purpose: This study aimed to evaluate the usefulness of the LDN-PSA (LacdiNAc-glycosylated-prostate specific antigen) in detecting clinically significant prostate cancer in patients suspected of having clinically significant prostate cancer on multiparametric magnetic resonance imaging.

Materials and methods: Patients with prostate specific antigen levels ranging between 3.0 ng/mL and 20 ng/mL and suspicious lesions with PI-RADS (Prostate Imaging-Reporting and Data System) category ≥3 were included prospectively. The LDN-PSA was measured using an automated 2-step Wisteria floribunda agglutinin lectin-anti-prostate specific antigen antibody sandwich immunoassay.

Results: Two hundred four patients were included. Clinically significant prostate cancer was detected in 105 patients. On multivariable logistic regression analysis, prostate specific antigen density (OR 1.61, P = .010), LDN-PSAD (OR 1.04, P = .012), highest PI-RADS category (3 vs 4, 5; OR 14.5, P < .0001), and location of the lesion with highest PI-RADS category (transition zone vs peripheral zone) (OR 0.34, P = .009) were significant risk factors for detecting clinically significant prostate cancer. Among the patients with the highest PI-RADS category 3 (n=113), clinically significant prostate cancer was detected in 28 patients. On multivariable logistic regression analysis to predict the detection of clinically significant prostate cancer in patients with the highest PI-RADS category 3, age (OR 1.10, P = .026) and LDN-PSAD (OR 1.07, P < .0001) were risk factors for detecting clinically significant prostate cancer.

Conclusions: LDN-PSAD would be a biomarker for detecting clinically significant prostate cancer in patients with prostate specific antigen levels ≤20 ng/mL and suspicious lesions with PI-RADS category ≥3. The use of LDN-PSAD as an adjunct to the use of prostate specific antigen levels would avoid unnecessary biopsies in patients with the highest PI-RADS category 3. Multi-institutional studies with large population are recommended.

Keywords: biomarkers; biopsy; magnetic resonance imaging; prostatic neoplasms.

MeSH terms

Humans
Magnetic Resonance Imaging
Male
Prostate-Specific Antigen*
Prostatic Neoplasms* / diagnostic imaging

Substances

Prostate-Specific Antigen