Approaches to urinary detection of prostate cancer

Abstract

Background: Prostate cancer is the most common cancer in American men that ranges from low risk states amenable to active surveillance to high risk states that can be lethal especially if untreated. There is a critical need to develop relatively non-invasive and clinically useful methods for screening, detection, prognosis, disease monitoring, and prediction of treatment efficacy. In this review, we focus on important advances as well as future efforts needed to drive clinical innovation in this area of urine biomarker research for prostate cancer detection and prognostication. Methods: We provide a review of current literature on urinary biomarkers for prostate cancer. We evaluate the strengths and limitations of a variety of approaches that vary in sampling strategies and targets measured; discuss reported urine tests for prostate cancer with respect to their technical, analytical, and clinical parameters; and provide our perspectives on critical considerations in approaches to developing a urine-based test for prostate cancer. Results: There has been an extensive history of exploring urine as a source of biomarkers for prostate cancer that has resulted in a variety of urine tests that are in current clinical use. Importantly, at least three tests have demonstrated high sensitivity (~90%) and negative predictive value (~95%) for clinically significant tumors; however, there has not been widespread adoption of these tests. Conclusions: Conceptual and methodological advances in the field will help to drive the development of novel urinary tests that in turn may lead to a shift in the clinical paradigm for prostate cancer diagnosis and management.

Identification of Specific Long Non-Coding Ribonucleic Acid Signatures and Regulatory Networks in Prostate Cancer in Fine-Needle Aspiration Biopsies

“…Prostate cancer is one of the most common cancers in men and ranges from low risk states amenable to active surveillance to high-risk states that can be lethal, especially if left untreated (Eskra et al, 2019). Although the diagnosis cornerstone of PCa has been prostate-specific antigen levels and numerous biomarkers have been introduced over the past decade, there is still a critical need for the development of relatively noninvasive and clinically useful methods for the screening, detection, prognosis, disease monitoring, and prediction of treatment efficacy of PCa.…”

In-Vitro Identification and In-Vivo Confirmation of DNA Methylation Biomarkers for Urothelial Cancer

“…Although the refinement of molecular technologies enables the analysis of cell-free DNA from urine, molecular approaches employing DNA from the urinary cell pellet display similar or even superior diagnostic value due to a substantial shedding of tumor cells into the urine [9,10]. However, urine does not only accumulate urothelial cells, but also cells from the prostate and kidney [5,11], making it necessary to account for potential cross-specificities of biomarkers. Because neoplasia of different organs including urological cancers also often share common molecular features [12], the urinary accumulation of cells stemming from different urological tissues has previously been utilized to identify biomarkers that, overall, detect urothelial, prostate and renal cancer [13].…”

Diagnostic Performance of PET/CT Using 18F-FACBC in Prostate Cancer: A Meta-Analysis

“…By 2000, the incidence of PCa was 4.55 per 100,000 males, and the case fatality rate was 5.59 per 100,000 people (2). In recent years, with the development of medical technology, its detection rate has increased year by year (3). Therefore, finding the right diagnosis followed by appropriate treatment is especially important.…”