{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,10]],"date-time":"2026-06-10T03:26:25Z","timestamp":1781061985343,"version":"3.54.1"},"reference-count":34,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2025,10,7]],"date-time":"2025-10-07T00:00:00Z","timestamp":1759795200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["The Prostate"],"published-print":{"date-parts":[[2026,2]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>This study evaluated the diagnostic accuracy of the novel biomarkers \u03b12,3\u2010sialylated prostate\u2010specific antigen percentage (S2,3PSA%) and S2,3PSA density (S2,3PSAD) in patients classified into Prostate Imaging Reporting and Data System (PI\u2010RADS) categories 3\u20135 and examined their utility in optimizing prostate cancer (PCa) diagnosis. S2,3PSA% reflects cancer\u2010specific N\u2010glycan modifications of free PSA, and its volume\u2010adjusted index S2,3PSAD may improve diagnostic precision.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We enrolled patients who underwent prostate biopsy at our institution between October 2023 and May 2025, all with measurable S2,3PSA%, S2,3PSAD, and PI\u2010RADS 3\u20135 lesions on magnetic resonance imaging (MRI) scans. S2,3PSA% was measured using the \u03bcTASWako i50 system, and S2,3PSAD was calculated by dividing S2,3PSA% by prostate volume. The diagnostic performance (area under the curve [AUC], sensitivity, and specificity) of S2,3PSA% and S2,3PSAD was compared with that of conventional markers (prostate\u2010specific antigen [PSA] and prostate\u2010specific antigen density [PSAD]). Avoided biopsies and missed clinically significant PCa (csPCa, ISUP Grade Group \u2265\u20092) were also evaluated.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Among 150 patients (median PSA, 7.18\u2009ng\/mL; prostate volume, 33.0\u2009mL; PSAD, 0.20; S2,3PSA%, 43.2%; S2,3PSAD, 1.21), PCa and csPCa were detected in 95 (63%) and 84 (56%) patients, respectively. PSA and PSAD showed AUCs of 0.607\/0.736 and specificities of 23.6%\/40.0%, at 85.3% sensitivity. By contrast, S2,3PSA% and S2,3PSAD achieved higher AUCs of 0.737\/0.757 and specificities of 45.5%\/49.1%. In MRI\u2010targeted biopsy (MRI\u2010TBx) cases (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u200985), PSA and PSAD had AUCs of 0.615\/0.758 and specificities of 18.8%\/43.8% at 88.7% sensitivity, whereas S2,3PSA% and S2,3PSAD reached 0.799\/0.810 with specificities of 53.1%\/56.3%. In PI\u2010RADS 3\/4, S2,3PSAD exhibited the highest AUC (0.773). At &lt;\u20090.85, avoided biopsy and csPCa miss rates were 26.4%\/8.8% (MRI\u2010TBx: 29.2%\/7.5%). No csPCa was missed in PI\u2010RADS 4 MRI\u2010TBx group, while PI\u2010RADS 5 showed higher miss rates.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>S2,3PSA% and S2,3PSAD offer superior diagnostic accuracy compared to conventional markers, especially in MRI\u2010TBx and PI\u2010RADS 3\/4, reducing unnecessary biopsies and minimizing missed csPCa. A biopsy remains warranted for PI\u2010RADS 5.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/pros.70078","type":"journal-article","created":{"date-parts":[[2025,10,7]],"date-time":"2025-10-07T13:10:10Z","timestamp":1759842610000},"page":"262-271","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Diagnostic Performance of the Novel Biomarker S2,3PSA Density for Prostate Biopsy Optimization in Prostate Imaging Reporting and Data System 3\u20135 Lesions"],"prefix":"10.1002","volume":"86","author":[{"ORCID":"https:\/\/orcid.org\/0009-0003-6703-9268","authenticated-orcid":false,"given":"Takanori","family":"Tokunaga","sequence":"first","affiliation":[{"name":"Department of Urology, Graduate School of Medicine Yamaguchi University Yamaguchi Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1872-8043","authenticated-orcid":false,"given":"Mitsuaki","family":"Nishioka","sequence":"additional","affiliation":[{"name":"Division of Laboratory Yamaguchi University Hospital Yamaguchi Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9279-3156","authenticated-orcid":false,"given":"Keita","family":"Kobayashi","sequence":"additional","affiliation":[{"name":"Department of Urology, Graduate School of Medicine Yamaguchi University Yamaguchi Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hiroshi","family":"Hirata","sequence":"additional","affiliation":[{"name":"Department of Urology, Graduate School of Medicine Yamaguchi University Yamaguchi Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kosuke","family":"Shimizu","sequence":"additional","affiliation":[{"name":"Department of Urology, Graduate School of Medicine Yamaguchi University Yamaguchi Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nakanori","family":"Fujii","sequence":"additional","affiliation":[{"name":"Department of Urology, Graduate School of Medicine Yamaguchi University Yamaguchi Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shoma","family":"Yoneda","sequence":"additional","affiliation":[{"name":"Division of Laboratory Yamaguchi University Hospital Yamaguchi Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rui","family":"Ebisui","sequence":"additional","affiliation":[{"name":"Division of Laboratory Yamaguchi University Hospital Yamaguchi Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aki","family":"Fujinaga","sequence":"additional","affiliation":[{"name":"Division of Laboratory Yamaguchi University Hospital Yamaguchi Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Toshihiko","family":"Kobayashi","sequence":"additional","affiliation":[{"name":"Division of Laboratory Yamaguchi University Hospital Yamaguchi Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Masahiro","family":"Tanabe","sequence":"additional","affiliation":[{"name":"Department of Radiology Yamaguchi University Graduate School of Medicine Yamaguchi Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yutaka","family":"Suehiro","sequence":"additional","affiliation":[{"name":"Division of Laboratory Yamaguchi University Hospital Yamaguchi Japan"},{"name":"Department of Oncology and Laboratory Medicine Yamaguchi University Graduate School of Medicine Yamaguchi Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9793-0399","authenticated-orcid":false,"given":"Takahiro","family":"Yamasaki","sequence":"additional","affiliation":[{"name":"Division of Laboratory Yamaguchi University Hospital Yamaguchi Japan"},{"name":"Department of Oncology and Laboratory Medicine Yamaguchi University Graduate School of Medicine Yamaguchi Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Koji","family":"Shiraishi","sequence":"additional","affiliation":[{"name":"Department of Urology, Graduate School of Medicine Yamaguchi University Yamaguchi Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2025,10,7]]},"reference":[{"key":"e_1_2_12_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(21)00950-8"},{"key":"e_1_2_12_3_1","doi-asserted-by":"publisher","DOI":"10.3322\/caac.21834"},{"key":"e_1_2_12_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(14)60525-0"},{"key":"e_1_2_12_5_1","doi-asserted-by":"publisher","DOI":"10.1002\/cncr.27594"},{"key":"e_1_2_12_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.eururo.2019.02.009"},{"key":"e_1_2_12_7_1","doi-asserted-by":"publisher","DOI":"10.1038\/sj.bjc.6605422"},{"key":"e_1_2_12_8_1","unstructured":"The Diagnostic Accuracy of the Age\u2010adjusted and Prostate Volume\u2010adjusted Biopsy Method in Males With Prostate Specific Antigen Levels of 4.1\u201310.0 ng\/mL \u2010 ITO \u2010 2002 \u2010 Cancer \u2010 Wiley Online Library.2025 https:\/\/acsjournals.onlinelibrary.wiley.com\/doi\/full\/10.1002\/cncr.10941?sid=nlm%3Apubmed."},{"key":"e_1_2_12_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.eururo.2015.07.029"},{"key":"e_1_2_12_10_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.eururo.2015.08.052"},{"key":"e_1_2_12_11_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.eururo.2019.02.033"},{"key":"e_1_2_12_12_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.euf.2019.06.014"},{"key":"e_1_2_12_13_1","doi-asserted-by":"publisher","DOI":"10.1097\/JU.0000000000000495"},{"key":"e_1_2_12_14_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.eururo.2014.08.011"},{"key":"e_1_2_12_15_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.juro.2015.01.091"},{"key":"e_1_2_12_16_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jval.2015.12.002"},{"key":"e_1_2_12_17_1","doi-asserted-by":"publisher","DOI":"10.1002\/pros.24894"},{"key":"e_1_2_12_18_1","doi-asserted-by":"publisher","DOI":"10.1002\/pros.24239"},{"key":"e_1_2_12_19_1","doi-asserted-by":"publisher","DOI":"10.1002\/pros.24917"},{"key":"e_1_2_12_20_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.eururo.2025.05.038"},{"key":"e_1_2_12_21_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41571-020-0332-z"},{"key":"e_1_2_12_22_1","doi-asserted-by":"crossref","unstructured":"K. A.Moses P. C.Sprenkle C.Bahler et al. NCCN Guidelines Insights: Prostate Cancer Early Detection Version 1.2023.2023 https:\/\/doi.org\/10.6004\/jnccn.2023.0014.","DOI":"10.6004\/jnccn.2023.0014"},{"key":"e_1_2_12_23_1","doi-asserted-by":"publisher","DOI":"10.1097\/JU.0000000000003492"},{"key":"e_1_2_12_24_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.eururo.2024.03.027"},{"key":"e_1_2_12_25_1","doi-asserted-by":"publisher","DOI":"10.1093\/glycob\/cwh071"},{"key":"e_1_2_12_26_1","doi-asserted-by":"publisher","DOI":"10.1093\/glycob\/cwm117"},{"key":"e_1_2_12_27_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10147-016-1049-y"},{"key":"e_1_2_12_28_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.eururo.2024.01.017"},{"key":"e_1_2_12_29_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.euo.2021.03.004"},{"key":"e_1_2_12_30_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.euo.2019.10.001"},{"key":"e_1_2_12_31_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.eururo.2020.03.048"},{"key":"e_1_2_12_32_1","doi-asserted-by":"publisher","DOI":"10.3390\/ijms18020470"},{"key":"e_1_2_12_33_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41416-021-01637-x"},{"key":"e_1_2_12_34_1","doi-asserted-by":"publisher","DOI":"10.1259\/bjr.20210509"},{"key":"e_1_2_12_35_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41391-021-00417-1"}],"container-title":["The Prostate"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/pros.70078","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,12,15]],"date-time":"2025-12-15T13:32:36Z","timestamp":1765805556000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/pros.70078"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,10,7]]},"references-count":34,"journal-issue":{"issue":"2","published-print":{"date-parts":[[2026,2]]}},"alternative-id":["10.1002\/pros.70078"],"URL":"https:\/\/doi.org\/10.1002\/pros.70078","archive":["Portico"],"relation":{},"ISSN":["0270-4137","1097-0045"],"issn-type":[{"value":"0270-4137","type":"print"},{"value":"1097-0045","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,10,7]]},"assertion":[{"value":"2025-07-04","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-09-30","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-10-07","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}