Comparison of PCA3 and T:E biomarkers’ diagnostic value using pair-matched post-DRE and pre-DRE urine samples
| Date | Start Page | End Page |
|---|---|---|
2024-02-28 | 1 | 1 |
Prieskyros nenurodytos.
Poster Number: C-24456
Purpose Accurately diagnosing clinically significant prostate cancer (csPCa) remains challenging. Although prostate biopsy is considered the gold standard for prostate cancer (PCa) diagnosis, it is nevertheless an invasive procedure associated with various potential complications. Therefore, non-invasive diagnostic methods, such as the examination of genetic urine biomarkers, are becoming increasingly relevant in daily clinical practice. While current guidelines recommend pre-biopsy mpMRI in any case, its availability is usually limited. In contrast, urine tests have shown promising results in predicting high-grade PCa.
Urine has the potential to be used as a versatile body fluid for developing new biomarkers for detecting csPCa. Genetic urinary tests could be performed before (pre-DRE) or after (post-DRE) prostate massage. If both alternatives have similar diagnostic accuracy, the pre-DRE test may be preferred as it can be performed at home, avoiding the inconvenient DRE procedure. Otherwise, when selecting a test version, it is critical to consider the sensitivity and specificity of the test as they relate to the number of detected cases and saved unnecessary biopsies, respectively.
The most researched urinary PCa-specific biomarkers are prostate cancer gene 3 (PCA3) and TMPRSS2:ERG (T:E) fusion. PCA3 was the first genetic biomarker approved as a diagnostic tool for PCa diagnosis.3 Unlike PSA, PCA3 is a genetic biomarker exhibiting high prostate cancer specificity. Gene fusion transcripts of transmembrane protease serine 2 (TMPRSS2) and erythroblastosis virus E26 oncogene homolog (ERG), also named TMPRSS2:ERG or T:E, have been known as promising urinary biomarkers in prostate cancer. T:E gene fusion is the most frequent genetic alteration found in PCa cases. The fusion leads to an overexpression of the transcription factor ERG, which is found in both early-stage and late-stage PCa. Using a post-DRE urine it was shown that the combination of PCA3 and T:E biomarkers has more diagnostic value than only PCA3. However, there is a lack of larger-size studies comparing these biomarkers in pre-DRE and post-DRE urine sampled from the same cohort of patients.
The main objective of this study was to compare the diagnostic value of two PCa-specific biomarkers (PCA3 and T:E) in post-DRE versus pre-DRE urine for the diagnosis of csPCa, as well as to compare the levels of the detected biomarkers. [...].