2235 SERUM ADIPOKINE LEVELS IMPROVE PROSTATE CANCER PREDICTION COMPARED TO CLINICAL DATA ONLY

Field: Medicine (Health Sciences)

You have accessJournal of UrologyProstate Cancer: Markers II1 Apr 20122235 SERUM ADIPOKINE LEVELS IMPROVE PROSTATE CANCER PREDICTION COMPARED TO CLINICAL DATA ONLY David Margel, Greg Trottier, Stanley Yap, Malik Elharram, Mike Connor, Bimal Bhindi, Antonio Finelli, Girish Kulkarny, and Neil Fleshner David MargelDavid Margel Toronto, Canada More articles by this author , Greg TrottierGreg Trottier Toronto, Canada More articles by this author , Stanley YapStanley Yap Toronto, Canada More articles by this author , Malik ElharramMalik Elharram Toronto, Canada More articles by this author , Mike ConnorMike Connor Toronto, Canada More articles by this author , Bimal BhindiBimal Bhindi Toronto, Canada More articles by this author , Antonio FinelliAntonio Finelli Toronto, Canada More articles by this author , Girish KulkarnyGirish Kulkarny Toronto, Canada More articles by this author , and Neil FleshnerNeil Fleshner Toronto, Canada More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2012.02.2411AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES In a previous study we demonstrated the potential of Adipokines (cytokine hormones released from adipocytes) as biomarkers for prostate cancer. However biomarkers are costly and should only be used clinically if they prove superior to existing models using clinical data. In this study we sought to determine whether these novel biomarkers offer additional diagnostic benefit in comparison to the use of clinical data alone. METHODS The analysis included data from 200 patients undergoing TRUS guided prostate biopsy at a single center. One-hundred PCa cases and 100 controls were chosen with an even mix of patients having a body mass indexes (BMI) above and below 27 kg/m2. Serum samples collected prior to prostate biopsy were used to measure adipokines (adiponectin, leptin, PAI, Resistin, HGF, IL-1 alfa, IL-6, IL-8, MCP-1, NGF and TNF-alfa) using Milliplex Multi-Analyte Profiling kits (Adipokine panels A and B; Millipore; Billerica, MA, USA). Multivariable models for predicting prostate cancer and high grade prostate cancer were created using predictors from three model selection methods (Forward, Backward, Stepwise) based on 1000 bootstrap samples. We compared a model composed of clinical data to one that includes both clinical data and serum adipokine levels. The ability of each model to predict PCa outcome was evaluated by area under the receiver operating characteristic curve (AUC of ROC). RESULTS The multivariable clinical model to predict prostate cancer included the following variables: Digital rectal examination, BMI, previous negative biopsy and PSA. The adipokine multivariable model included these clinical variables and the levels of the following adipokines: MCP-1, TNF alfa, IL-6 and HGF. The AUC of the ROC curve for predicting prostate cancer was 0.67 (95%CI 0.59-0.74) for the clinical data only vs. 0.745 (95%CI 0.67-0.81) for the model including adipokines (p=0.018). The clinical model to predict high grade prostate cancer included: DRE, PSA and previous biopsy. The adipokines added to predict high grade cancers were: NGF and MCP-1. The AUC of the ROC curve for predicting high grade prostate cancer was 0.75 (95%CI 0.67-0.83) for the clinical data only vs. 0.79 (95%CI 0.71-0.86) for the model including adipokines (p=0.0532). CONCLUSIONS We have demonstrated that adding serum adipokine levels increases the accuracy of models predicting both prostate cancer and high grade prostate cancer. The results of this study require further validation using a larger multi-center cohort. © 2012 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 187Issue 4SApril 2012Page: e901-e902 Advertisement Copyright & Permissions© 2012 by American Urological Association Education and Research, Inc.MetricsAuthor Information David Margel Toronto, Canada More articles by this author Greg Trottier Toronto, Canada More articles by this author Stanley Yap Toronto, Canada More articles by this author Malik Elharram Toronto, Canada More articles by this author Mike Connor Toronto, Canada More articles by this author Bimal Bhindi Toronto, Canada More articles by this author Antonio Finelli Toronto, Canada More articles by this author Girish Kulkarny Toronto, Canada More articles by this author Neil Fleshner Toronto, Canada More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...