Prostate最新文献

{"title":"Real-World Overall Survival Comparison of Enzalutamide and Abiraterone In First- and Second-Line Setting of Metastatic Castration-Resistant Prostate Cancer.","authors":"András Horváth, Celia Blasszauer, Ida Komka, Dániel Reibl, Boris Hadaschik, Tamás Fazekas, Pawel Rajwa, Àron Soós, Anikó Valikovics, Péter Nyirády, Tibor Szarvas","doi":"10.1002/pros.24923","DOIUrl":"10.1002/pros.24923","url":null,"abstract":"<p><strong>Background: </strong>While their indications overlap, no clinical trials have compared abiraterone and enzalutamide for overall survival (OS) in mCRPC.</p><p><strong>Methods: </strong>A large, country-wide health insurance database (2013-2023) was assessed for the OS comparison between abiraterone and enzalutamide.</p><p><strong>Results: </strong>Overall, 3497 patients were identified with first- (n = 2215) or second-line (n = 1282) abiraterone or enzalutamide treatment (only 66 received both drugs sequentially). Enzalutamide-treated patients had longer OS both in the first- (HR:0.84; 95%CI:0.74-0.96; p = 0.008) and the second-line setting (HR:0.88; 95%CI:0.78-0.99; p = 0.043), respectively.</p><p><strong>Conclusions: </strong>This health insurance-registry-based study suggests that, in the real-world mCRPC setting, enzalutamide is superior to abiraterone in terms of OS.</p>","PeriodicalId":54544,"journal":{"name":"Prostate","volume":" ","pages":"1151-1154"},"PeriodicalIF":2.6,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144250811","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Hormone Therapy Usage Is Associated With Adverse Cardiovascular Events in Prostate Cancer Patients of the All of Us Research Program Cohort.","authors":"Yuanchu J Yang, Chenjie Zeng, Kerry R Schaffer, Tam C Tran, Peter J Sauer, Lincoln A Brown, Ben H Park, Joshua C Denny","doi":"10.1002/pros.24913","DOIUrl":"10.1002/pros.24913","url":null,"abstract":"<p><strong>Background: </strong>Hormone therapy (HT) has greatly improved overall survival for prostate cancer patients, but may also influence cardiovascular health in an already high-risk population.</p><p><strong>Methods: </strong>This retrospective cohort study examined participants in the All of Us Research Program with prostate cancer, had no prior history of adverse cardiovascular events, and were either treated or not treated with HT. HT was defined as GnRH agonists, GnRH antagonists, abiraterone, androgen antagonists, or androgen receptor pathway inhibitors. We defined adverse cardiovascular event as myocardial infarctions, heart failure, or strokes. Time to adverse cardiovascular event was defined using longitudinal electronic health record data. We evaluated whether HT use affected the risk of adverse cardiovascular events using a Cox regression model adjusted for established cardiovascular risk factors.</p><p><strong>Results: </strong>The final cohort included 5156 participants. After adjustment for cardiovascular risk covariates, HT treatment was associated with increased risk of adverse cardiovascular event (HR: 1.22; 95% CI: 1.01-1.48; p = 0.03). In participants with pre-treatment dyslipidemia, HT usage was associated with increased risk of adverse cardiovascular events (HR: 1.52; 95% CI: 1.19-1.95; p < 0.001). In participants without pre-treatment dyslipidemia, no association was found (HR: 0.96; 95% CI: 0.71-1.30; p = 0.81).</p><p><strong>Conclusions: </strong>Our results show that HT-associated cardiovascular risk may be synergistically amplified by dyslipidemia. These results suggest that risk stratification by dyslipidemia status may improve cardiovascular outcomes for prostate cancer survivors.</p>","PeriodicalId":54544,"journal":{"name":"Prostate","volume":" ","pages":"1077-1086"},"PeriodicalIF":2.6,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144276740","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"History of Vasectomy Is not Associated With Prostate Cancer Progression in Men on Active Surveillance.","authors":"Aurora J Grutman, Yuezhou Jing, Derek K Ng, Patricia K Landis, Bruce J Trock, Christian P Pavlovich","doi":"10.1002/pros.70001","DOIUrl":"10.1002/pros.70001","url":null,"abstract":"<p><strong>Background: </strong>Despite decades of debate, there is little resolution about the relationship between vasectomy and prostate cancer, let alone disease progression in men on active surveillance. We sought to compare progression risk in men on active surveillance with or without history of vasectomy.</p><p><strong>Methods: </strong>We performed a retrospective review of data from our institutional Active Surveillance Program. To assess cancer outcomes, we evaluated baseline demographic data, prostate-specific antigen (PSA), PSA density, and estimates of biopsy tumor volume in men with low-grade (Grade Group 1) prostate cancer with or without vasectomy history. Men with a vasectomy were further categorized by time between vasectomy and prostate cancer diagnosis to evaluate whether this latent period influenced disease progression. We defined disease progression as grade reclassification (GR; upgrading) to Grade Group ≥ 2 on any surveillance biopsy. Treatment in absence of GR and death not due to prostate cancer were considered competing risks. The Fine & Gray model was used to calculate univariate and multivariate subdistribution hazard ratios accounting for competing risk.</p><p><strong>Results: </strong>A total of 1565 men with Grade Group 1 prostate cancer at diagnosis were included, of whom 373 men reported prior vasectomy and 1192 reported no history of vasectomy. GR to ≥ Grade Group 2 on any surveillance biopsy occurred in 112 (30.0%) men with prior vasectomy, compared to 386 (32.4%) men without vasectomy, at any surveillance biopsy. After adjustment for baseline characteristics, neither a history of vasectomy nor the time from vasectomy to prostate cancer diagnosis was associated with a significant risk of progression to higher grade disease.</p><p><strong>Conclusions: </strong>This is the first investigation of prostate cancer progression risk and history of vasectomy in men on active surveillance. Given that prostate cancer is the most common cancer diagnosis in men in the USA, identification of risk factors for adverse clinical outcomes is necessary so patients may make informed management decisions.</p>","PeriodicalId":54544,"journal":{"name":"Prostate","volume":" ","pages":"1143-1150"},"PeriodicalIF":2.6,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144477903","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"SBRT Boost in Prostate Cancer: Progress Made, Questions Remain.","authors":"Cem Onal, Aysenur Elmali, Birhan Demirhan, Ozan Cem Guler","doi":"10.1002/pros.24919","DOIUrl":"10.1002/pros.24919","url":null,"abstract":"","PeriodicalId":54544,"journal":{"name":"Prostate","volume":" ","pages":"1155-1156"},"PeriodicalIF":2.6,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144144255","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Genomic Signatures Correlating With Adverse Pathologic Features in Men Eligible for Active Surveillance.","authors":"Jamie Michael, Eric V Li, Mitch Huang, Nicole Handa, Nalin Kundu, Austin Ho, Hiten D Patel, James A Proudfoot, Sai Kaushik Shankar Ramesh Kumar, Edward M Schaeffer, Elai Davicioni, Ridwan Alam, Ashley E Ross","doi":"10.1002/pros.24924","DOIUrl":"10.1002/pros.24924","url":null,"abstract":"<p><strong>Background: </strong>Genomic biomarkers offer opportunities to improve risk stratification for patients with prostate cancer. We performed a transcriptomic profile of active surveillance (AS)-eligible patients who underwent radical prostatectomy (RP) to understand genomic associations with adverse pathologic features (APF) at RP.</p><p><strong>Methods: </strong>Patients considered AS-eligible (NCCN low-favorable intermediate risk) but proceeded to RP from February 2012 to September 2024 were identified from our prospective institutional database. Outcomes were classified by presence or absence of APF at RP, which was defined as grade group (GG) ≥ 3, pT3b, or pN1 disease. Previously established genomic signatures of interest were compared between the two groups. Scaled multivariable logistic regression was performed to evaluate associations between multiple genomic classification systems and the outcome of APF.</p><p><strong>Results: </strong>There were 184 AS-eligible patients, of whom 153 (83.2%) had favorable intermediate risk disease and 31 (16.8%) had low risk disease. There were 41 patients (22.3%) who had APF at RP. The incidence of favorable intermediate risk disease did not differ between those with and without APF (80.5% vs. 83.9%, p = 0.64). Patients with APF had a higher baseline PSA (5.6 ng/mL vs. 4.9 ng/mL, p = 0.01) and Decipher score (0.55 vs. 0.41, p = 0.004) compared to those without APF. On scaled logistic regression with adjustment for log-transformed PSA, the Decipher score, PTEN loss, activated CD4, and ERG positive rate were significantly associated with APF (OR 1.61, 95% CI 1.11-2.32, p = 0.01). Of ten other previously published genomic classifiers, nine were significantly associated with APF.</p><p><strong>Conclusion: </strong>AS-eligible patients with APF at RP demonstrate differences in gene expression when compared to those without APF. We established that multiple existing genomic classifiers not previously studied in this context demonstrate the ability to predict APF in this patient population. Inclusion of genomics in the risk stratification of AS-eligible patients has the potential to better inform clinical decisions.</p>","PeriodicalId":54544,"journal":{"name":"Prostate","volume":" ","pages":"1114-1120"},"PeriodicalIF":2.6,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144334459","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Germline Testing for Prostate Cancer Patients: Evidence-Based Evaluation of Genes Recommended by NCCN Guidelines.","authors":"Jianfeng Xu, Jim Lu, Marta Gielzak, S Lilly Zheng, Lucy Lu, Jun Wei, Brandon Cornell, Zhuqing Shi, Qiang Wang, Huy Tran, Valentina Engelmann, Annabelle Ashworth, Kirk Lin, Ashley E Ross, Patrick C Walsh, Catherine Marshall, Jun Luo, William B Isaacs, Brian T Helfand, Christian P Pavlovich","doi":"10.1002/pros.24918","DOIUrl":"10.1002/pros.24918","url":null,"abstract":"<p><strong>Background: </strong>Approximately 50% of prostate cancer (PCa) patients meet the National Comprehensive Cancer Network (NCCN) guidelines for germline testing at diagnosis. However, the selection of genes for testing, their supporting evidence, and clinical interpretation remain poorly understood.</p><p><strong>Methods: </strong>An evidence-based evaluation of the recommended genes was conducted using data from the UK Biobank and Johns Hopkins School of Medicine, including 22,052 PCa patients and 191,055 unaffected controls. Association of germline pathogenic/likely pathogenic (P/LP) variants in each gene was tested using logistic regression, adjusting for age and genetic background.</p><p><strong>Results: </strong>Among the 11 NCCN-recommended PCa-related genes, significant associations (p < 0.0045) were identified between germline P/LP variants of five genes (HOXB13, BRCA2, ATM, CHEK2, and MSH2) and PCa risk. Additionally, BRCA2 and ATM variants were significantly associated with PCa aggressiveness. Of the 19 NCCN-recommended genes related to PARPi sensitivity, consistent evidence supported an enhanced response to PARPi therapy in patients with BRCA2 alterations, with weaker evidence for BRCA1, and limited supporting evidence for the remaining genes. Germline P/LP variants in BRCA2 and BRCA1 were observed in 0.77% and 0.14% of unselected PCa patients, respectively. Notably, no published study specifically assessed the efficacy of germline alterations, which were considerably rarer than somatic mutations.</p><p><strong>Conclusion: </strong>Supporting statistical evidence is available for only a subset of the NCCN-recommended genes for germline testing. This evidence-based analysis may aid urologists-particularly those without specialized genetics training-in understanding germline testing for PCa risk assessment, prognosis, and treatment decision-making in clinical practice.</p>","PeriodicalId":54544,"journal":{"name":"Prostate","volume":" ","pages":"1087-1095"},"PeriodicalIF":2.6,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144129615","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Role of Cell-Cycle Proliferation Test, Triple Hit Phenotype, and TMPRSS2-ERG Expression to Evaluate the Risk of Progression in Prostate Cancer Patients Under Active Surveillance.","authors":"Marco Oderda, Giulia Orlando, Giorgio Calleris, Giulia Capella, Luisa Delsedime, Eleonora Duregon, Paola Francia di Celle, Donatella Pacchioni, Ian Marc Bonapace, Zaibunnisa Zaibunnisa, Daniele D'Agate, Gabriele Montefusco, Claudia Filippini, Mauro Papotti, Paolo Gontero","doi":"10.1002/pros.24921","DOIUrl":"10.1002/pros.24921","url":null,"abstract":"<p><strong>Background: </strong>An accurate estimation of progression risk in patients with prostate cancer (PCa) amenable to active surveillance (AS) is still an unmet need. Among available biomarkers, we considered Prolaris cell-cycle progression (CCP) test, \"triple hit\" phenotype (ERG overexpression, PTEN and prostein expression loss) and elevated expression levels of TMPRSS2-ERG gene fusions.</p><p><strong>Methods: </strong>We performed a case-control study, enrolling patients that entered the AS programme at our tertiary referral Institution. Men subsequently undergoing radical prostatectomy for progression were considered as \"cases\", while men still on AS at the end of the follow-up period were labeled as \"controls\". CCP test, triple hit and TMPRSS2-ERG expression analyses were performed on tumoral tissue retrieved from biopsies at enrollment. Their ability to distinguish \"cases\" and \"controls\" was evaluated. According to power analysis, the study required 40 patients.</p><p><strong>Results: </strong>Patients had comparable baseline characteristics. CCP test suggested to continue AS in 75% of controls and to undergo an active treatment in 75% of cases. CCP molecular score (HR 8.5, p = 0.02) was significantly associated with progression in multivariable logistic regression. No significant differences were found in terms of \"triple hit\" or TMPRSS2:ERG expression. IHC analysis was feasible only in 17 patients due to insufficient material.</p><p><strong>Conclusions: </strong>CCP test may be a useful tool to estimate the risk of progression in PCa patients and guide the decision between AS and active treatment. Triple hit phenotype or TMPRSS:ERG fusion status was not associated with progression.</p>","PeriodicalId":54544,"journal":{"name":"Prostate","volume":" ","pages":"1104-1113"},"PeriodicalIF":2.6,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144175853","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comprehensive Genomic Profiling Testing for Castration-Resistant Prostate Cancer in Advanced Elderly Patients: A Single-Center Retrospective Cohort Study.","authors":"Takafumi Fukushima, Keisuke Goto, Yoshinori Nakano, Shinsaku Tasaka, Kyohsuke Iwane, Ryo Tasaka, Kohei Kobatake, Akihiro Goriki, Asuka Toshida, Akiko Abe, Misako Ishihara, Hikaru Nakahara, Masanori Motonaga, Kentaro Tokumo, Yasutoshi Fujii, Hayes Clair Nelson, Hiroaki Niitsu, Shinya Ohara, Yuji Urabe, Wataru Okamoto, Eiso Hiyama, Koji Arihiro, Takao Hinoi, Nobuyuki Hinata","doi":"10.1002/pros.24926","DOIUrl":"10.1002/pros.24926","url":null,"abstract":"<p><strong>Background: </strong>Prostate cancer (PCa) is the second most common solid tumor in men, and its incidence is strongly dependent on age. With the aging global population, this poses a significant medical and sociodemographic issue. As treatment options for castration-resistant prostate cancer (CRPC) expand, the proportion of elderly patients with CRPC is expected to increase. Comprehensive genomic profiling (CGP) testing is becoming increasingly utilized for PCa; however, evidence on age-related outcomes or benefits is limited. This study aimed to evaluate the efficacy of CGP testing in advanced elderly patients with CRPC compared to younger patients.</p><p><strong>Methods: </strong>We conducted a single-center, retrospective cohort study at Hiroshima University, including Japanese men aged ≥ 20 years who underwent CGP testing for CRPC between January 1, 2021, and May 31, 2024. Patients were categorized into the following two groups: the \"advanced elderly group\" (≥ 75 years) and the \"younger group\" (< 75 years). Clinical data were retrospectively extracted from medical records. CGP testing was performed using the FoundationOne® CDx, FoundationOne® Liquid CDx, Gurdant360® CDx, PleSSision Exome, or OncoGuide™ NCC Oncopanel System. Pathogenic alterations were categorized into relevant subgroups. Statistical analyzes were performed to compare patient backgrounds, genomic subgroups, and outcomes between the age groups.</p><p><strong>Results: </strong>Overall, 85 patients (median age: 74 years) were included in the analysis, with 38 and 47 in the advanced elderly and younger groups, respectively. No significant differences were observed in baseline clinical characteristics other than age. CGP testing identified 355 pathogenic variants (140 and 215 in the advanced elderly and younger groups, respectively), with similar distributions of alteration types across the two groups. Among the subgroups, DNA repair and homologous recombination repair-related gene alterations were significantly more frequent in the younger group (p = 0.017) than in the advanced elderly group. Overall survival (OS) did not differ significantly between the age groups. However, patients who received systemic chemotherapy based on CGP testing results had significantly better OS than those who did not receive systemic therapy (p = 0.045). This trend remained significant in the advanced elderly group (p = 0.006).</p><p><strong>Conclusions: </strong>CGP testing appears to offer clinical benefits for patients with CRPC, regardless of age.</p>","PeriodicalId":54544,"journal":{"name":"Prostate","volume":" ","pages":"1134-1142"},"PeriodicalIF":2.6,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144267893","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Downregulation of NONO Suppresses Proliferation, Migration, and Invasion in Metastatic Prostate Cancer.","authors":"Anna-Lena Lemster, Sarah Grünhagen, Sarah Schmalfeld, Florian Lenz, Anna Natzius, Anne Offermann, Sven Perner, Jiong Zhang, Verena Sailer, Jutta Kirfel","doi":"10.1002/pros.24925","DOIUrl":"10.1002/pros.24925","url":null,"abstract":"<p><strong>Background: </strong>As prostate cancer (PCa) remains one of the leading causes of cancer-related death in men, it is important to develop effective therapeutic approaches for the treatment of metastatic PCa and to improve the accuracy of prognosis for aggressive tumors. Non-POU domain-containing octamer-binding (NONO) is involved in RNA transport and almost all steps of gene regulation, and aberrant expression is associated with tumorigenesis in various tumor entities.</p><p><strong>Methods: </strong>Immunohistochemical analysis of the expression of NONO was performed in a cohort of 405 patient samples, including 54 benign prostate tissues, 250 primary prostate tumors, and 101 metastatic tissue samples. To assess the role of NONO in PCa cells, siRNA-mediated knockdown of NONO in the metastatic PCa cell lines PC3 and DU145, followed by a series of functional assays including proliferation, transwell, western blotting, and real-time quantitative PCR, was used.</p><p><strong>Results: </strong>The current study showed that the nuclear expression of NONO increases during the progression of PCa and is highest in distant metastases. NONO regulates cell proliferation by increasing the expression of cell cycle-related genes. In addition, NONO modulates migration and invasion in PCa cells.</p><p><strong>Conclusion: </strong>Overall, these results suggest inhibition of NONO may be a promising approach for the treatment of metastatic PCa.</p>","PeriodicalId":54544,"journal":{"name":"Prostate","volume":" ","pages":"1121-1133"},"PeriodicalIF":2.6,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144287082","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Multimarker Model for Prostate Cancer Risk Assessment: Improving Diagnostic Accuracy Beyond PSA.","authors":"Penglu Yang, Bin Yang","doi":"10.1002/pros.24920","DOIUrl":"10.1002/pros.24920","url":null,"abstract":"<p><strong>Objective: </strong>This study aimed to evaluate the association between biochemical markers and prostate cancer (PCa) risk by analyzing patients with benign prostatic hyperplasia (BPH) and PCa. Additionally, the study sought to assess the diagnostic accuracy of a multimarker model compared to prostate-specific antigen (PSA) alone.</p><p><strong>Methods: </strong>A cross-sectional study was conducted with data from 2931 patients (1374 with BPH and 1557 with PCa) from the Prostate Cancer Data Set of the National Population Health Data Center. Biochemical markers, including PSA, apolipoproteins, lipid profiles, and metabolic markers (calcium and phosphate), were analyzed. Univariate and multivariate logistic regression analyses were performed to assess the associations with PCa risk. The diagnostic performance of the multimarker model was evaluated using receiver operating characteristic (ROC) curve analysis.</p><p><strong>Results: </strong>Total PSA levels were significantly higher in PCa patients, and the free/total PSA ratio was lower (p < 0.001). Apolipoprotein A1, LDL cholesterol, calcium, and phosphate were also significantly associated with PCa risk (p < 0.001). The multivariate logistic regression model, incorporating multiple markers, showed improved diagnostic accuracy (AUC 0.731, 95% CI: 0.713-0.749), with sensitivity of 68.4% and specificity of 65.8%.</p><p><strong>Conclusions: </strong>Combining multiple biochemical markers with PSA enhances the diagnostic accuracy for PCa, offering additional predictive value. This multimarker approach has the potential to improve PCa screening and reduce unnecessary biopsies.</p>","PeriodicalId":54544,"journal":{"name":"Prostate","volume":" ","pages":"1096-1103"},"PeriodicalIF":2.6,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144144252","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}