Voided Urine Sample in the Diagnosis of Prostate Cancer in Patients with Serum PSA Ranging between 2.6 to 10 ng/mL

Shridhar C. Ghagane, Rangrez Shadab, R. Nerli, Shreyas Rai, Madhukar L. Thakur, L. Gomella
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Abstract

Introduction: Prostate cancer (PCa) cells are known to be shed into the prostatic urethra and thus can be collected through a voided urine sample. In this preliminary prospective study, we have assessed the feasibility of detecting cancer of the prostate using a voided urine sample and targeting the genomic VPAC receptors in patients with lower urinary tract symptoms and a serum PSA ranging between 2.6 to 10 ng/mL. Materials & Methods: Patients ≥40 years old, with lower urinary tract symptoms and serum prostate-specific antigen (PSA) ranging between 2.6 - 10 ng/mL formed the study group. The voided urine sample was collected from all these patients for biomarker testing. All patients underwent a standard 12-core prostate biopsy. The results of the histopathological studies were then compared to the results of the urine biomarker. Results: A total of 76 male subjects presented to our hospital with lower urinary tract symptoms and a serum PSA ≥ 2.6 and ≤ 10 ng/mL. The voided urine sample was positive for malignant cells in 24/25 (96%) patients with PCa. There was one case of a false negative in this group. Histopathological examination of the core biopsy specimens was positive for malignancy in 23 (92%) cases of PCa. Conclusions: Voided urine samples can be used to diagnose PCa by targeting the VPAC receptors that are expressed on malignant cells. This test is highly sensitive and serum PSA levels or Gleason’s score have no impact on the sensitivity of this test.
在诊断血清 PSA 介于 2.6 至 10 纳克/毫升之间的前列腺癌患者时使用排出的尿液样本
前言:众所周知,前列腺癌(PCa)细胞会脱落到前列腺尿道中,因此可以通过排空的尿液样本收集到前列腺癌细胞。在这项初步的前瞻性研究中,我们评估了在有下尿路症状和血清 PSA 介于 2.6 至 10 纳克/毫升之间的患者中使用排空尿样和靶向基因组 VPAC 受体检测前列腺癌的可行性。材料与方法研究对象为年龄≥40 岁、有下尿路症状且血清前列腺特异性抗原(PSA)介于 2.6 - 10 纳克/毫升之间的患者。研究人员采集了所有患者的排空尿液样本,用于生物标记物检测。所有患者都接受了标准的 12 核前列腺活检。然后将组织病理学研究结果与尿液生物标志物结果进行比较。结果共有 76 名男性患者因出现下尿路症状、血清 PSA ≥ 2.6 且≤ 10 纳克/毫升而到我院就诊。24/25(96%)名 PCa 患者的排空尿液样本中恶性细胞呈阳性。其中一例为假阴性。23例(92%)PCa患者的核心活检标本组织病理学检查呈恶性肿瘤阳性。结论排出的尿液样本可以通过靶向恶性细胞上表达的 VPAC 受体来诊断 PCa。该检测灵敏度很高,血清 PSA 水平或格里森评分对该检测的灵敏度没有影响。
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