Serum PSA, DRE, DNA Methylation, PCA3, And TMPRSS2:ERG In Expressed Prostatic Secretion As Non-Invasive Predictors Of Biopsy Outcome

Main Category: Prostate / Prostate Cancer
Also Included In: Urology / Nephrology
Article Date: 29 Jun 2008 - 0:00 PDT

email to a friend   printer friendly   opinions  

ORLANDO, FL (UroToday.com) - New biomarkers for prostate cancer are taking stage alongside PSA.

Clark and colleagues assessed utility of several biomarkers detected in expressed prostatic secretions (EPS) to predict prostate cancer biopsy yield. Biomarkers studied included DNA methylation, PCA3, and the TMPRSS2:ERG gene fusion product. EPS specimens were collected as part of a prospective patient-blinded study in individuals undergoing prostate needle biopsy. PSA and DRE results were available for all patients. Correlation of biomarker levels with prostate biopsy results was assessed using logistic regression and compared to improvement over predictive value of PSA/DRE. DNA methylation products of several genes produced little improvement in predictive value of PSA/DRE alone. Sum of methylation values of APC, RAR , RASSFI and GSTPI, however, did demonstrate mild improvement over baseline: Area Under Curve (AUC) = 0.721 vs. 0.662-0.705 for PSA/DRE alone. Expression of PCA3 yielded similar results (AUC of 0.692). TMPRSS2:ERG gene fusion product expression was the best performer with AUC of 0.823. TMPRSS2:ERG was also valuable in differentiating between high and low grade disease.

The authors conclude that TMPRSS2:ERG gene fusion product expression combined with serum PSA and DRE is the best diagnostic marker for EPS specimens.

Presented by Jarrod P Clark, MD, et al., at the Annual Meeting of the American Urological Association (AUA) - May 17 - 22, 2008. Orange County Convention Center - Orlando, Florida, USA.

Reported by UroToday.com Contributing Editor Alexander Kutikov, MD

UroToday - the only urology website with original content written by global urology key opinion leaders actively engaged in clinical practice.

To access the latest urology news releases from UroToday, go to: www.urotoday.com

Copyright © 2008 - UroToday

• Additional
• References
• Citations