The combination of AroCell TK 210 ELISA with Prostate Health Index or prostate-specific antigen density can improve the ability to differentiate prostate cancer from noncancerous conditions

Prostate. 2019 Jun;79(8):856-863. doi: 10.1002/pros.23791. Epub 2019 Mar 19.


Background: Prostate-specific antigen (PSA) is an established tumour marker for prostate cancer (PCa). Serum thymidine kinase 1 is a possible new marker for the detection of PCa. The aim of the study was to investigate the diagnostic value of the AroCell TK 210 enzyme-linked immunosorbent assay (ELISA) together with free PSA, [-2]proPSA, and Prostate Health Index (PHI) in differentiating PCa from benign urological conditions.

Methods: Serum samples from 140 patients with PSA values in the range between 2 and 10 µg/L were collected at the Ljubljana University Medical Centre and the Maribor University Medical Centre. Thymidine kinase (TK1) protein levels were determined using the AroCell TK 210 ELISA and PSA-related parameters analysed with commercial assays.

Results: Serum TK1 protein, total and free PSA, proPSA, PSA density (PSAD), and PHI levels in patients with confirmed PCa were significantly higher than in patients with benign urological conditions (P < 0.05). Overall, the AroCell TK 210 ELISA results showed a significant correlation with PHI ( r = 0.25, P = 0.0031). Receiver-operating characteristic curve analyses were used to compare the area under the curve (AUC) of TK 210 ELISA, PHI, and PSA density. For PHI, the AUC was 0.73, comparable to those of TK 210 ELISA (0.67) and PSAD (0.66), with no significant differences in pairwise comparisons (PHI vs TK 210 ELISA P = 0.32, PHI vs PSAD P = 0.24, and TK 210 ELISA vs PSAD P = 0.95). The AUC for the combination of TK1 plus PSAD was significantly higher than those for the individual PSA-related biomarkers and marginally PHI, while the AUC for the combination of TK1 plus PHI was significantly higher than those for the individual PSA-related biomarkers except for PHI and marginally for PSAD. Total PSA concentration was the only marker, that was significantly higher in patients with an increasing Gleason grade.

Conclusions: These results suggest that TK1 protein determinations together with PHI or PSAD could be a valuable additional tool in PCa management.

Keywords: benign prostatic disease; prostate cancer; prostate health index; prostate-specific antigen; thymidine kinase 1.

MeSH terms

  • Aged
  • Aged, 80 and over
  • Diagnosis, Differential
  • Enzyme-Linked Immunosorbent Assay / methods*
  • Humans
  • Kallikreins / blood*
  • Male
  • Middle Aged
  • Prostate-Specific Antigen / blood*
  • Prostatic Diseases / blood
  • Prostatic Diseases / diagnosis*
  • Prostatic Neoplasms / blood
  • Prostatic Neoplasms / diagnosis*
  • Thymidine Kinase / blood


  • Thymidine Kinase
  • thymidine kinase 1
  • KLK3 protein, human
  • Kallikreins
  • Prostate-Specific Antigen