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Evaluation of serum fatty acid binding protein-4 (FABP-4) as a novel biomarker to predict biopsy outcomes in prostate biopsy naïve patients

  • Urology - Original Paper
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Abstract

Objectives

To investigate the role of serum fatty acid-binding protein-4 (FABP-4) as a surrogate of obesity and metabolic syndrome in the prediction of the outcome of prostate biopsy.

Methods

A prospective pilot study was conducted for patients undergoing prostate needle biopsy (PNB) for clinically suspected prostate cancer (PCa) between June 2016 and August 2017. Fifty consecutive patients with biopsy-proven PCa were included as study group and 50 consecutive patients with negative biopsy were included as a control group. Receiver Operating Characteristic (ROC) curve was used to calculate the area under the curve (AUC) to compare the accuracy of the different parameters in the diagnosis as well as the presence of high-grade PCa (Gleason score 8–9) at PNB. Predictors of the outcome were analyzed using univariate and multivariate logistic regression analysis.

Results

FABP-4 (AUC: 0.75; P < 0.001) and PSA-density (AUC: 0.84; P < 0.001) were the most accurate to detect PCa at PNB. On multivariate analysis, FABP-4 > 22.5 ng/ml (OR: 16.6; 95% CI 2.8–98; P = 0.002) and PSA-density > 0.38 ng/ml/ml OR: 17.7; 95% CI 5.3–59; P < 0.001) were independent predictors of PCa detection. Regarding high-grade PCa at PNB, FABP-4 (AUC: 0.79; P < 0.001) and %Free-PSA (AUC: 0.75; P < 0.001) were the most accurate. Independent predictors of high-grade PCa were FABP-4 > 32.3 ng/ml OR: 9.2; 95% CI 1.8–45; P = 0.006) and %Free-PSA ≤ 21.9 (OR: 5.5; 95% CI 1.1–27; P = 0.03).

Conclusions

FABP-4 is an independent predictor for both the diagnosis and high-grade Gleason score at PNB. This novel biomarker might have a promising role in optimizing PNB outcomes.

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Abbreviations

FBS:

Fasting blood sugar

FABP-4:

Fatty acid-binding protein-4

MS:

Metabolic syndrome

PCa:

Prostate cancer

PNB:

Prostate needle biopsy

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Authors and Affiliations

  1. Urology Department, Urology and Nephrology Center, Mansoura University, Mansoura, Egypt

    Ahmed M. Harraz, Amani Ismail & Hassan Abol-Enein

  2. Faculty of Science, Biochemistry Department, Mansoura University, Mansoura, Egypt

    Nora Atia & A. F. Abdel-Aziz

  3. Radiology Department, Urology and Nephrology Center, Mansoura University, Mansoura, Egypt

    Abdallah Shady, Hashim Farg, Hady Gabr & Mohamed Fouda

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  1. Ahmed M. Harraz
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  2. Nora Atia
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Correspondence to Ahmed M. Harraz.

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Harraz, A.M., Atia, N., Ismail, A. et al. Evaluation of serum fatty acid binding protein-4 (FABP-4) as a novel biomarker to predict biopsy outcomes in prostate biopsy naïve patients. Int Urol Nephrol 52, 1483–1490 (2020). https://doi.org/10.1007/s11255-020-02426-w

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