Purpose: To investigate whether EPCA-2 (a prostate matrix nuclear protein) can be a more helpful marker in prostate cancer diagnosis.
Materials and Methods: 176 patients enrolled in this study had abnormal prostate specific antigen (PSA) or digital rectal examination and were candidates for prostate needle biopsy. Blood samples were obtained from each patient prior to biopsy and the samples were frozen for EPCA-2 measurement. Patients diagnosed with cancer were assigned to the case group and those with benign prostate hyperplasia (BPH) were included in the control group. Univariate and multivariable analyses were done to assess the relationship between different independent variables with cancer diagnosis. The diagnostic power of EPCA-2 for cancer was estimated at different levels of PSA according to the ROC curve.
Results: The mean(± SD) age of cancer cases was 70.33(± 9.02) years while it was 63.34(± 9.47) years for BPH cases (P < .01). EPCA-2 and PSA were also significantly different between cancer and BPH cases (P < .001). The multivariable logistic regression showed that EPCA-2 has a significant relationship with cancer diagnosis (OR=1.009, P = .021). After controlling other variables following stratification for PSA, it was shown that EPCA-2 and cancer were correlated just when PSA was >10 (P < .001). AUC was 0.694 for cancer prediction by EPCA-2 when PSA was >10 ng/mL.
Conclusion: EPCA-2 has the power of differentiating BPH from cancer in prostate cancer suspects. This suggests that EPCA-2 can be helpful in diagnosing prostate cancer and can be a preventive test to avoid unnecessary biopsies considering PSA and age of the patient.