Yoneyama T, Yamamoto H, Yoneyama MS, et al. - According to findings, α2,3-sialylated prostate-specific antigen (S23PSA) density (S23PSAD) outperformed conventional strategies but was comparable to multiparametric magnetic resonance imaging in terms of diagnostic performance.

• In 71 radical prostatectomy specimens, tissue-based quantification of S23PSA, sialyltransferase, and sialidase gene expression was performed.

• S23PSAD diagnostic performance was investigated in 1,099 men who were retrospectively enrolled in a multicenter systematic biopsy (SBx) cohort.

• S23PSA was significantly higher in Gleason pattern 4 and 5 vs benign prostate tissue.

• In the retrospective cohort, S23PSAD outperformed tPSA and PSA density (PSAD) in detecting PC.

• In the prospective cohort, S23PSAD outperformed tPSA, PSAD, and PI-RADS, and S23PSAD + PI-RADS + DRE + tPSA outperformed DRE + tPSA+PI-RADS with an MRI–TBx avoidance rate of 30%.