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Here, we developed an automated microcapillary electrophoresis\u2010based immunoassay system for measuring serum core\u2010type fucosylated prostate\u2010specific antigen (PSA) and evaluated whether the serum fucosylated PSA index (FPI) can detect high\u2010risk prostate cancer. Core\u2010type fucosylated\u2010free PSA was measured by our automated microcapillary electrophoresis\u2010based immunoassay system with <jats:italic>Pholiota squarrosa<\/jats:italic> lectin. The FPI was calculated from total PSA and the percentage of fucosylated\u2010free PSA. The optimum model to predict Gleason grade (GG) \u22652 was constructed by multivariate logistic regression analysis. Discrimination was assessed by determining the area under the receiver operator characteristic curve (AUC). The study included 252 men who underwent prostate needle biopsy due to elevated serum PSA levels (4\u201020\u2009ng\/mL), including 138 with GG \u22652. A higher FPI was significantly associated with GG (<jats:italic>P<\/jats:italic>\u2009&lt;\u2009.0001). Multivariate logistic regression analysis showed that age, prostate volume and FPI were significant predictors of GG \u22652. The AUC of FPI and the model were 0.729 (95% confidence interval [CI]: 0.668\u20100.790) and 0.837 (95% CI: 0.788\u20100.886), respectively, compared to 0.629 (95% CI: 0.561\u20100.698) for PSA. Decision curve analysis showed the superior benefit of FPI and the model when compared to PSA. In a cohort with serum PSA levels &lt;20\u2009ng\/mL, FPI could differentiate high\u2010risk prostate cancer from biopsy\u2010negative or low\u2010risk prostate cancer. Therefore, FPI could be a useful adjunct in prostate biopsy counseling for men with abnormal PSA levels.<\/jats:p>","DOI":"10.1002\/ijc.33517","type":"journal-article","created":{"date-parts":[[2021,2,17]],"date-time":"2021-02-17T20:08:48Z","timestamp":1613592528000},"page":"3111-3118","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":30,"title":["Serum core\u2010type fucosylated prostate\u2010specific antigen index for the detection of high\u2010risk prostate cancer"],"prefix":"10.1002","volume":"148","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6774-7497","authenticated-orcid":false,"given":"Kazutoshi","family":"Fujita","sequence":"first","affiliation":[{"name":"Department of Urology Osaka University Graduate School of Medicine  Suita Japan"},{"name":"Department of Urology Kindai University Faculty of Medicine  Osakasayama Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Koji","family":"Hatano","sequence":"additional","affiliation":[{"name":"Department of Urology Osaka University Graduate School of Medicine  Suita Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eisuke","family":"Tomiyama","sequence":"additional","affiliation":[{"name":"Department of Urology Osaka University Graduate School of Medicine  Suita Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4701-5635","authenticated-orcid":false,"given":"Yujiro","family":"Hayashi","sequence":"additional","affiliation":[{"name":"Department of Urology Osaka University Graduate School of Medicine  Suita Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Makoto","family":"Matsushita","sequence":"additional","affiliation":[{"name":"Department of Urology Osaka University Graduate School of Medicine  Suita Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mutsumi","family":"Tsuchiya","sequence":"additional","affiliation":[{"name":"Department of Urology Osaka University Graduate School of Medicine  Suita Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tomoyasu","family":"Yoshikawa","sequence":"additional","affiliation":[{"name":"Fujifilm\u2010Wako Inc.  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