MpMRI and genetic urinary test value for clinically significant prostate cancer early detection
| Date | Start Page | End Page |
|---|---|---|
2023-07-05 | 1 | 1 |
no. C-13814
Purpose: The diagnosis and management of prostate cancer are evolving every year. Digital rectal examination (DRE) and prostate specific antigen (PSA) screening are usually followed by subsequent DRE-directed or transrectal ultrasound (TRUS)-guided biopsy sampling. However, this technique allows to detect prostate cancer only 30% to 40% of cases. Men undergoing TRUS-guided biopsy are at risk of several complications, including lower urinary tract symptoms (up to 25% of cases), hematuria, rectal bleeding, hematospermia, infection, pain, urinary retention, erectile dysfunction and even mortality. Avoiding unnecessary biopsy is critical to protect men to undergo an uncomfortable and potentially risky invasive procedure and to avoid labeling them with a cancer diagnosis which is highly related to psychological stress.
Magnetic resonance imaging (MRI) use in daily prostate cancer detection is increasing and has proven to be a valuable tool in cancer diagnostics. Multiparametric MRI (MpMRI) in prostate cancer patients has demonstrated better diagnosis while performing targeted biopsy and decreased diagnosis of clinically insignificant prostate cancer.
Urine is a versatile body fluid for non-invasive urological malignancies detection. It is known, that prostate cancer biomarkers are likely to be found in urine sample because of the anatomical localization of the prostate next to the bladder apex and the proximal part of the urethra. The most investigated biomarkers are PCA3 and TMPRSS2:ERG fusion. PCA3 is a – a prostate specific long non-coding RNR overexpressed in 95% of prostate cancer cases. TMPRSS2:ERG is androgen regulated gene fusion which is believed to play a major role in prostate tumorogenesis.
Non-invasive methods, such as urinary biomarkers’ detection along with mpMRI could be more suitable for diagnostics of prostate cancer in biopsy-naïve patients. The objective of this study was to evaluate mpMRI, genetic urinary test (GUT) separately and in combination as an indicator of early significant prostate cancer (PCa). [...].