Prostate-based biofluids for the detection of prostate cancer: a comparative study of the diagnostic performance of cell-sourced RNA biomarkers

Roberts, Matthew J., Richards, Renee S., Chow, Clement W. K., Doi, Suhail A. R., Schirra, Horst Joachim, Buck, Marion, Samaratunga, Hemamali, Perry-Keene, Joanna, Payton, Diane, Yaxley, John, Lavin, Martin F. and Gardiner, Robert A. (2016) Prostate-based biofluids for the detection of prostate cancer: a comparative study of the diagnostic performance of cell-sourced RNA biomarkers. Prostate International, 4 3: 97-102. doi:10.1016/j.prnil.2016.04.002


Author Roberts, Matthew J.
Richards, Renee S.
Chow, Clement W. K.
Doi, Suhail A. R.
Schirra, Horst Joachim
Buck, Marion
Samaratunga, Hemamali
Perry-Keene, Joanna
Payton, Diane
Yaxley, John
Lavin, Martin F.
Gardiner, Robert A.
Title Prostate-based biofluids for the detection of prostate cancer: a comparative study of the diagnostic performance of cell-sourced RNA biomarkers
Journal name Prostate International   Check publisher's open access policy
ISSN 2287-903X
2287-8882
Publication date 2016-09-01
Sub-type Article (original research)
DOI 10.1016/j.prnil.2016.04.002
Open Access Status DOI
Volume 4
Issue 3
Start page 97
End page 102
Total pages 6
Place of publication Amsterdam, Netherlands
Publisher Elsevier BV
Collection year 2017
Language eng
Formatted abstract
Background: Prostate cancer (PCa) diagnosis requires improvement with the aid of more accurate biomarkers. Postejaculate urethral washings (PEUW) could be a physiological equivalent to urine obtained following rectal prostatic massage, the current basis for the prostate cancer antigen 3 (PCA3) test. The aim of this study was to investigate if PEUW contained prostate-based material, evidenced by the presence of prostate specific antigen (PSA), and to evaluate the diagnostic performance of PEUW-based biomarkers.

Methods: Male patients referred for elevated serum PSA or abnormal digital rectal examination provided ejaculate and PEUW samples. PSA, PCA3, and β2-microglobulin (β2M) were quantified in ejaculate and PEUW and compared with absolute and clinically significant (according to D'Amico criteria) PCa presence, as determined by biopsies. Diagnostic performance was determined and compared with serum PSA using receiver operating characteristic analysis.

Results: From 83 patients who provided PEUW samples, paired analysis with ejaculate samples was possible for 38 patients, while analysis in an unpaired, extended cohort was possible for 62 patients. PSA and PCA3 were detected in PEUW, normalized to β2M, and PCA3:PSA was calculated. In predicting absolute PCa status, PCA3:β2M in ejaculate [area under the curve (AUC) 0.717] and PEUW (AUC 0.569) were insignificantly better than PCA3:PSA (AUC 0.668 and 0.431, respectively) and comparable with serum PSA (AUC 0.617) with similar trends observed for the extended cohort. When considering clinically significant PCa presence, serum PSA in the comparison (AUC 0.640) and extended cohorts (AUC 0.665) was comparable with PCA3: β2M (AUC 0.667) and PCA3:PSA (AUC 0.605) in ejaculate, with lower estimates for PEUW in the comparison (PCA3: β2M AUC 0.496; PCA3:PSA AUC 0.342) and extended (PCA3: β2M AUC 0.497; PCA3:PSA AUC 0.469) cohorts. The statistical analysis was limited by sample size.

Conclusion: PEUW contains prostatic material, but has limited diagnostic accuracy when considering cell-derived DNA analysis. PCA3-based markers in ejaculate are comparable to serum PSA and digital rectal examination–urine markers.
Keyword Biomarker
Ejaculate
MRNA
Prostate cancer
Prostate cancer antigen 3
Prostate specific antigen
Q-Index Code C1
Q-Index Status Provisional Code
Institutional Status UQ

 
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