The Percentage of Free PSA and Urinary Markers Distinguish Prostate Cancer from Benign Hyperplasia and Contribute to a More Accurate Indication for Prostate Biopsy

The study validated a quadruplex assay of urinary markers (PCA3, AMACR, TRPM8, MSMB) in 299 men to distinguish prostate cancer (CaP) from benign prostate hyperplasia (BPH). It found that combining % free PSA with urinary markers significantly improved the accuracy of prostate biopsy indications, achieving an AUC of 0.728 in the main cohort and 0.753 in a subset of 146 men. The study concluded that these markers could help reduce unnecessary prostate biopsies by better distinguishing between CaP and BPH, despite inflammation in BPH affecting PCA3 and PSA levels. Further research was suggested to validate these findings and explore prostate inflammation evaluation.