MP6-01 URINARY BIOMARKERS FOR THE DETECTION OF PROSTATE CANCER IN PATIENTS WITH HIGH-GRADE PROSTATIC INTRAEPITHELIAL NEOPLASIA (HGPIN).

Abstract

You have accessJournal of UrologyProstate Cancer: Markers II1 Apr 2015MP6-01 URINARY BIOMARKERS FOR THE DETECTION OF PROSTATE CANCER IN PATIENTS WITH HIGH-GRADE PROSTATIC INTRAEPITHELIAL NEOPLASIA (HGPIN). Juan M. Bastarós, Tamara Sequeiros, José Placer, Jacques Planas, Lucas Regis, Milagros Sánchez, Marina Rigau, Melania Montes, Inés de Torres, Jaume Reventós, Andreas Doll, and Juan Morote Juan M. BastarósJuan M. Bastarós More articles by this author , Tamara SequeirosTamara Sequeiros More articles by this author , José PlacerJosé Placer More articles by this author , Jacques PlanasJacques Planas More articles by this author , Lucas RegisLucas Regis More articles by this author , Milagros SánchezMilagros Sánchez More articles by this author , Marina RigauMarina Rigau More articles by this author , Melania MontesMelania Montes More articles by this author , Inés de TorresInés de Torres More articles by this author , Jaume ReventósJaume Reventós More articles by this author , Andreas DollAndreas Doll More articles by this author , and Juan MoroteJuan Morote More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2015.02.248AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Men with suspicion of prostate cancer (PCa) are referred for prostatic biopsy (PB), and some of them will present HGPIN (a commonly accepted precursor of PCa) in this first PB. Those patients frequently face several years of active surveillance including repeat PBs. Previously, our research group showed that PCA3 and PSGR gene expression in urine sediment could be useful biomarkers for the detection of PCa in benign prostatic hyperplasia cases. Although with a lower efficacy, we also observed that PCA3 was able to detect PCa in those patients with a previous diagnosis of HGPIN. The aim of this study is to identify urinary biomarkers that could differentiate between indolent HGPIN cases and those who actually present PCa. METHODS From a cohort of 114 patients with diagnosis of HGPIN (in a first PB recommended due to increased serum PSA levels (>4ng/mL) and/or an abnormal diagnostic DRE), urine sediment samples were obtained, after DRE within days before a repeat biopsy after a posterior follow up of at least two years. Reverse-transcriptase PCR (RTqPCR) of extracted RNA was conducted to determine expression of 6 endogenous genes and 17 target genes, all of them putative PCa biomarkers. Univariate tests and univariate and multivariate logistic regressions were used to examine associations between PCa diagnostic status and testing genes. All possible models were created using combinations of the most significant genes obtained in the univariate analysis and multivariate logistic regression was applied to them. The number of PBs potentially avoided by the use of the proposed biomarkers was calculated. RESULTS By univariate statistical analysis of the obtained data, it was found that PSMA, PCA3, PSGR, GOLM, KLK3 and CDH1 were significant predictors of PCa in repeat PB. Multiplex models that use the PCa biomarkers KLK3, PSMA, PSGR, GOLM1 and CDH1 (AUC=0.81-0.86) outperform all the assayed genes, including PCA3 (AUC=0.70), when used individually. With a fixed sensitivity of 95%, the specificity of the models was of 41–58%, compared to the 30% of PCA3. Applying these models, it would be possible to save from 33% and up to 47% of the repeat biopsies practiced. CONCLUSIONS A multiplexed RTqPCR assay on urine sediments from patients presenting for a repeat PB due to a diagnosis of HGPIN can significantly improve the predictive ability when compared to PCA3 or any other assayed gene when used alone. Further evaluation and validation of these biomarkers in larger and independent cohorts is highly desirable, in order to confirm these results. © 2015 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 193Issue 4SApril 2015Page: e54 Advertisement Copyright & Permissions© 2015 by American Urological Association Education and Research, Inc.MetricsAuthor Information Juan M. Bastarós More articles by this author Tamara Sequeiros More articles by this author José Placer More articles by this author Jacques Planas More articles by this author Lucas Regis More articles by this author Milagros Sánchez More articles by this author Marina Rigau More articles by this author Melania Montes More articles by this author Inés de Torres More articles by this author Jaume Reventós More articles by this author Andreas Doll More articles by this author Juan Morote More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...