Altered prostate-specific antigen (PSA) glycosylation patterns can be useful biomarkers in detecting high-grade prostate cancer (HGPC). The microfluidic immunoassay system can analyse α2,3-linked sialylated PSA (α2,3-Sia-PSA) and α1,6-linked fucosylated PSA (α1,6-Fuc-PSA) using different lectins, Mackkia amurensis agglutinin and Pholiota squarrosa lectin, respectively. Here, we investigated the diagnostic value of simultaneous analysis of α2,3-Sia-PSA and α1,6-Fuc-PSA for the detection of HGPC.
Men with serum PSA levels of 4–20 ng/mL who underwent prostate biopsy were included. The model to predict HGPC (Gleason grade ≥2) was constructed by multivariate logistic regression analysis, in combination with α2,3-Sia-PSA and α1,6-Fuc-PSA (SF index).
In the development cohort (n = 150), the SF index showed good discrimination for HGPC (area under the receiver-operating curve (AUC) 0.842; 95% confidence interval (CI) 0.782–0.903), compared to the single PSA test (AUC 0.632, 95% CI 0.543–0.721), α2,3-Sia-PSA (AUC 0.711, 95% CI 0.629–0.793) and α1,6-Fuc-PSA (AUC 0.738, 95% CI 0.657–0.819). Decision-curve analysis showed the superior benefit of the SF index. In the validation cohort (n = 57), the SF index showed good discrimination for HGPC (AUC 0.769, 95% CI 0.643–0.895).
The SF index could differentiate HGPC, providing useful information for decision making for prostate biopsy in men with abnormal PSA levels.
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This work was supported by the Japan Society for the Promotion of Science KAKENHI [grant numbers 20K18090 and T18K091320].
The authors declare no competing interests.
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This study was approved by the institutional review board of the Osaka University Graduate School of Medicine (No. 10008-6). Consent from participants was obtained from investigators at enrolment.
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Hatano, K., Yoneyama, T., Hatakeyama, S. et al. Simultaneous analysis of serum α2,3-linked sialylation and core-type fucosylation of prostate-specific antigen for the detection of high-grade prostate cancer. Br J Cancer 126, 764–770 (2022). https://doi.org/10.1038/s41416-021-01637-x
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