Low Specificity of Fibroblast Growth Factor 23 in Differentiating Prostate Cancer from Benign Prostate Hyperplasia

Abstract

Finding a biomarkers that will be more sensitive and specific for the diagnosis of either prostate cancer or BPH as well as differentiating the two clinical conditions beyond the use of total PSA and all the its modifications has been of considerable interest for the Clinicians and other health care providers. This study here posited some further clarifications in this direction. This work attempted to determine the sensitivity/specificity of fibroblast growth factor23 in prostate cancer and benign prostate hyperplasia (BPH) patients at a tertiary centre in Ibadan Nigeria. Anthropometric characteristics, serum fibroblast growth factor 23 (FGF-23) and total prostate specific antigen (tPSA) were determined in 60 patients with histopathological diagnosis of BPH and Pca and thirty age matched control. Informed consent was obtained from all the participants in the study. Serum FGF-23 was determined using enzyme-linked immunosorbent serologic assay (ELISA) and total PSA was determined using enzyme immunoassay (EIA). The statistical analysis was done using SPSS version 20.0 and Receiver operating characteristics (ROC) curve was used to determine the sensitivity and specificity for both FGF-23 and PSA. A p-value < 0.05 was considered significant. The mean FGF-23 was significantly higher in Pca and BPH compared to control. Expectedly, the mean total PSA was also significantly higher in Pca compared to BPH and control. There was a statistically significant AUC for FGF-23(AUC = 0.697, p = 0.009) between PCa patients and controls while PSA was not statistically significant. (AUC = 0.564, p = 0.391). At FGF-23 cut off of 221.45pg/ml, sensitivity and specificity were 66.7 and 83.3 respectively while at PSA cut off of 1.217ng/ml, sensitivity and specificity were 56.7 and 86.7 for diagnosis of prostate cancer respectively. However, FGF23 has low specificity in distinguishing patients with prostate cancer from BPH. FGF-23 appears more specific in the diagnosis of both PCa and BPH than total PSA and may be promising in differentiate these two disease entities from individuals without them.