JU open plus最新文献

{"title":"Effect of Acupuncture on Urine Production and Storage in Prostate Cancer Survivors With Nocturia: Exploratory Analysis of a Randomized Clinical Trial.","authors":"Allison G Booher, Jake Mao, Jaspreet Sandhu, Divya Ajay, Sigrid V Carlsson, Vincent Laudone, Michael J Morris, Kevin T Liou","doi":"10.1097/JU9.0000000000000493","DOIUrl":"https://doi.org/10.1097/JU9.0000000000000493","url":null,"abstract":"<p><strong>Background: </strong>Nocturia is multifactorial condition, but most treatments only target urine production or storage in isolation. Acupuncture has been shown to decrease nocturia, but its mechanisms remain unclear. This study explores the preliminary effects of acupuncture on urine production and storage to inform future mechanistic hypotheses.</p><p><strong>Methods: </strong>We conducted a secondary analysis of 3-day frequency volume charts from a clinical trial in which prostate cancer survivors with nocturia were randomized to receive acupuncture or usual care (waitlist control [WLC]). Within-group posttreatment changes and between-group differences were compared by paired and two-sample t-tests in the total sample and in subgroups stratified by the presence of nocturnal polyuria at baseline.</p><p><strong>Results: </strong>In the total sample (N = 35), acupuncture reduced nocturia episodes (-1.1 vs -0.4, <i>P</i> = .016) and increased mean urine volume per nighttime void (+30.3 mL vs -0.6 mL, <i>P</i> = .047) relative to the WLC group. In the subgroup with nocturnal polyuria, acupuncture reduced nocturia episodes (-1.1, <i>P</i> = .0057) and reduced the ratio of nocturnal urine volume to total urine volume (-10.7%, <i>P</i> = .02); nocturia episodes also decreased in the WLC group (-0.4, <i>P</i> = .018), but there was no significant change in the ratio of nocturnal urine volume to total urine volume.</p><p><strong>Conclusions: </strong>Among prostate cancer survivors with nocturia, acupuncture demonstrated joint effects on urine production and storage. Acupuncture also reduced nocturia across different types of underlying urinary dysfunction, including nocturnal polyuria. If confirmed, these preliminary findings could inform a novel treatment approach uniquely suited for the multifactorial etiology of nocturia.</p>","PeriodicalId":74033,"journal":{"name":"JU open plus","volume":"4 9","pages":"e00104"},"PeriodicalIF":0.0,"publicationDate":"2026-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13626574/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149119376","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Erratum: May 2026 JUOP Editorial: Highlights from the 2026 EAU in London-Part 3-Benign Conditions.","authors":"Bernardo Rocco, Francesco Porpiglia, Koosha Moosavi, Daniele Fettucciari, Francesco Del Giudice, Francesco Prata, Claudio Brancelli, Serena Maruccia, Giuseppe Carrieri, John W Davis","doi":"10.1097/JU9.0000000000000538","DOIUrl":"https://doi.org/10.1097/JU9.0000000000000538","url":null,"abstract":"<p><p>[This corrects the article DOI: 10.1097/JU9.0000000000000486.].</p>","PeriodicalId":74033,"journal":{"name":"JU open plus","volume":"4 9","pages":"e00103"},"PeriodicalIF":0.0,"publicationDate":"2026-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13626579/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149119568","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Salvage Metastasis-Directed Therapy Without Androgen Deprivation for Positron Emission Tomography-Defined Oligorecurrent Prostate Cancer: Results of the SOAR Phase II Trial.","authors":"Evan Crockett, Bogdana Schmidt, Olivia Rodriguez, Adam Taylor, Emma Braun, Samuel Leonhart, Umang Swami, Kenneth M Boucher, Lisa Chapman, Hillary Davis, Jeff Linton, Erica Mangelson, Skyler Johnson, Jonathan Tward, Bismarck Odei, Jeff Yap, Sumati Gupta, Manish Kohli, Neeraj Agarwal, Christopher Dechet, Brock O'Neil, Benjamin L Maughan, Alejandro Sanchez","doi":"10.1097/JU9.0000000000000517","DOIUrl":"10.1097/JU9.0000000000000517","url":null,"abstract":"<p><strong>Purpose: </strong>Advanced molecular imaging has enabled detection of oligorecurrent prostate cancer (PCa) at low PSA levels, but optimal management of positron emission tomography (PET)-defined recurrence remains uncertain. We conducted a phase II trial to evaluate biochemical response, oncologic outcomes, and safety of salvage metastasis-directed therapy (MDT) delivered without concurrent androgen deprivation therapy (ADT).</p><p><strong>Materials and methods: </strong>Twenty men with PET-defined oligometastatic recurrence (≤ 10 nodal or osseous lesions) after radical prostatectomy were prospectively enrolled (2019-2023). Treatment was assigned based on disease distribution: bone-directed radiotherapy (arm A), salvage lymph node dissection (sLND; arm B), or combined therapy (arm C). The primary endpoint was a ≥ 50% PSA decline at 6 months; secondary endpoints included PSA progression, ADT-free survival, and treatment-related morbidity.</p><p><strong>Results: </strong>The median age was 65 years (IQR 61.5-70.0); 18 patients had nodal-only recurrence, and 2 had bone-only disease. At 6 months, 8 of 20 patients (40%) achieved ≥ 50% PSA reduction. Over a median follow-up of 11.4 months, 12-month PSA-PFS was 74.1% (95% confidence interval [CI] 54.8%-100%) and ADT-free survival was 71.4% (95% CI 52.7%-96.6%), with a median of 13.3 months. Among sLND patients, pathologic carcinoma was confirmed in 15 of 18 (83%) and pathologic assessment frequently revealed more extensive nodal disease than predicted by PET. No Clavien-Dindo grade III-V complications occurred.</p><p><strong>Conclusions: </strong>Salvage MDT without ADT is feasible, safe, and associated with meaningful biochemical responses in selected patients with PET-defined oligorecurrent PCa. Pathologic findings demonstrate that PET imaging may underestimate true nodal disease burden, supporting comprehensive treatment strategies and further prospective investigation.</p>","PeriodicalId":74033,"journal":{"name":"JU open plus","volume":"4 9","pages":"e00101"},"PeriodicalIF":0.0,"publicationDate":"2026-09-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13623071/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149083056","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Validation of Comprehensive Prostate Cancer Assessment on Sexual Health for Men Who Have Sex With Men (COMPASS).","authors":"Tsz Kin Lee, Richard J Wassersug, Gary W Dowsett, John Oliffe, Darryl Mittledorf, Erik Wibowo","doi":"10.1097/JU9.0000000000000510","DOIUrl":"https://doi.org/10.1097/JU9.0000000000000510","url":null,"abstract":"<p><strong>Purpose: </strong>The purpose of this study was to validate a questionnaire that can be used to assess sexual function and practices of men with prostate cancer (PCa), who have sex with men.</p><p><strong>Materials and methods: </strong>Previously, we developed a questionnaire with 13 domains on specific aspects of sexual quality of life for men who have sex with men: sex drive, ejaculation, erection, orgasm, general sexual questions, receptive anal intercourse, insertive anal intercourse, solo masturbation, receiving masturbation, receiving oral sex, sex with regular partner(s), sex with casual partner(s), and urinary leakage. Men who have sex with men with PCa completed the questionnaire twice, with each completion separated by 2 to 4 weeks. Statistical analyses included factor analysis, test/retest validation with Cronbach alpha, and intraclass correlation. Since urinary leakage is significantly more common with radical prostatectomy than with radiation, we have compared urinary leakage with treatment history as an independent validation. Multivariate regression was performed to explore the impact of demographics and treatment parameters on different domains.</p><p><strong>Results: </strong>All domains except erection were loaded to a single factor in factor analysis. Cronbach alpha was good-to-excellent for all domains except ejaculation. All domains were highly significant for intraclass correlation, with ejaculation being the lowest. Urination leakage was worse for men treated with radical prostatectomy compared with external beam radiation. Multivariate regression showed that radical prostatectomy and external beam radiation might not affect receptive anal sex and receptive oral sex, respectively. Previous treatment with androgen deprivation therapy and brachytherapy was related to low scores for each domain.</p><p><strong>Conclusions: </strong>We validated a questionnaire with 13 domains that included various aspects of sexual quality of life for men with PCa, who have sex with men. The questionnaire is now ready for further study in research and clinical settings.</p>","PeriodicalId":74033,"journal":{"name":"JU open plus","volume":"4 9","pages":"e00095"},"PeriodicalIF":0.0,"publicationDate":"2026-09-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13600354/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149042318","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Erratum: Safety and Efficacy of a Novel Direct Bladder Wall Stimulation Device in Canines: Erratum.","authors":"Anagha U Kotkar, Zachariah J Sperry, Carlos J Anaya, Andrew S Bohannon, Nicolette D Jackson, Collin R Johnson, Emily M LaFrance, Stacey E Seidl","doi":"10.1097/JU9.0000000000000504","DOIUrl":"10.1097/JU9.0000000000000504","url":null,"abstract":"<p><p>[This corrects the article DOI: 10.1097/JU9.0000000000000469.].</p>","PeriodicalId":74033,"journal":{"name":"JU open plus","volume":"4 8","pages":"e00087"},"PeriodicalIF":0.0,"publicationDate":"2026-08-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13475724/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148762816","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Health Care Utilization and Costs Associated With Blue-Light vs White-Light Cystoscopy: A Real-World Bladder Cancer Population.","authors":"Mark D Tyson, Mouneeb M Choudry, Chad McKee, Shiv Kalaria, Cerise James, Nicole M Engel-Nitz, Mary G Johnson, Timothy L Barnes","doi":"10.1097/JU9.0000000000000491","DOIUrl":"10.1097/JU9.0000000000000491","url":null,"abstract":"<p><strong>Purpose: </strong>Compared with white-light cystoscopy (WLC), blue-light cystoscopy (BLC) enhances detection of non-muscle-invasive bladder cancer (NMIBC), especially carcinoma in situ (CIS). However, its effects on health care resource utilization and cost burden have not been fully elucidated. This study assessed the economic implications of BLC vs WLC.</p><p><strong>Materials and methods: </strong>We conducted a retrospective cohort analysis with claims data from the Optum Research Database between June 2011 and May 2023. Patients who underwent BLC or WLC were identified, and white-light patients were matched 6:1 to blue-light patients by index year and time between bladder cancer diagnosis and cystoscopy. Inverse probability of treatment weighting was used to adjust for baseline differences. Health care resource utilization and total and bladder cancer-specific costs were calculated on a per-patient-per-month basis.</p><p><strong>Results: </strong>The final cohort included 794 blue-light and 4764 white-light patients. Before weighting, claims coded for CIS were more frequent in blue-light patients (19.6% vs 8.8%; <i>P</i> < .001). Blue-light patients underwent more upper-tract imaging (71.8% vs 57.8%; <i>P</i> < .001), BCG (24.2% vs 15.8%; <i>P</i> < .001), and biomarker testing (65.0% vs 34.9%; <i>P</i> < .001). After weighting, blue-light patients had a higher mean number of bladder cancer-related ambulatory visits per month (1.3 vs 1.0; <i>P</i> = .004). However, neither all-cause health care resource utilization (3.47 vs 3.21; <i>P</i> = .11) nor total cost ($2987.93 vs $2886.16, per patient per month, <i>P</i> = .65) differed significantly between cohorts.</p><p><strong>Conclusions: </strong>BLC is associated with greater health care resource utilization for NMIBC without significantly elevating health care costs, suggesting that enhanced diagnostic strategies can be implemented without added financial burden in real-world practice.</p>","PeriodicalId":74033,"journal":{"name":"JU open plus","volume":"4 8","pages":"e00085"},"PeriodicalIF":0.0,"publicationDate":"2026-08-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13446911/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148687014","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Predictors of Prolonged Time to Ambulation After Radical Prostatectomy in a 23-hour Ambulatory Surgery Center.","authors":"Maricka Bennett, Emily Vertosick, Joanna Serafin, Tiana Y Sepahpour, Sigrid V Carlsson, Daniel Stein, Vincent Laudone, Melissa Assel, Anoushka M Afonso","doi":"10.1097/JU9.0000000000000459","DOIUrl":"10.1097/JU9.0000000000000459","url":null,"abstract":"<p><strong>Purpose: </strong>The purpose of this study was to identify factors associated with delayed ambulation in patients undergoing radical prostatectomy in an ambulatory surgery setting.</p><p><strong>Materials and methods: </strong>Patients who underwent ambulatory robot-assisted radical prostatectomy between January 11, 2016, and December 27, 2022, were eligible for inclusion. Predictors of interest included age, body mass index (BMI), American Society of Anesthesiologists physical status (1/2 vs 3/4), operative time, volume of intravenous fluids, estimated blood loss, intraoperative oral morphine equivalents, and postoperative nausea and vomiting (PONV) risk using 4-point Apfel scoring.</p><p><strong>Results: </strong>The cohort included 3626 patients who underwent ambulatory prostatectomy. Median time to ambulation was 5.1 hours (IQR 4.2-6.3). Among predictors, only BMI and Apfel score were statistically significantly associated with ambulation. Patients with higher BMI were more likely to ambulate the same day of surgery; however, the effect size was small: A man with PONV risk score 2 and BMI 25 has a 94% chance of ambulating the same day compared with 95% for a man with BMI 30. A PONV risk score of 3 was associated with more than double the odds of next-day ambulation compared with scores ≤ 2 (odds ratio, OR 2.18, 95% confidence interval, CI, 1.69-3.66, <i>P</i> = .006).</p><p><strong>Conclusions: </strong>Our study identified an association between preoperative PONV risk score and delayed ambulation. Although high PONV risk is more commonly observed in women, our findings suggest that awareness of PONV risk and its management on postoperative ambulation should also be investigated in the context of prostate surgery.</p>","PeriodicalId":74033,"journal":{"name":"JU open plus","volume":"4 7","pages":"e00066"},"PeriodicalIF":0.0,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13317909/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148364529","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparative Outcomes and Management of Vesicourethral Anastomotic Stenosis After Contemporary Standard and Pelvic-Fascia-Sparing Robotic-Assisted Radical Prostatectomy Techniques.","authors":"Behnam Nabavizadeh, Kyle A Blum, Judy Zhong, Joshua Winograd, Ang Li, Jack M Dowd, Chung-Fu Lin, Anh T Nguyen, Lee C Zhao, Keith J Kowalczyk, Jim C Hu","doi":"10.1097/JU9.0000000000000461","DOIUrl":"10.1097/JU9.0000000000000461","url":null,"abstract":"<p><strong>Purpose: </strong>Vesicourethral anastomotic stenosis (VUAS) occurs after 1 to 3% of robotic-assisted radical prostatectomies (RARPs). Pelvic fascia-sparing techniques preserve more native anatomy and may reduce stenoses, but evidence is lacking. The aim of this study was to compare stenosis incidence, management, and outcomes after standard vs pelvic fascia-sparing RARP.</p><p><strong>Materials and methods: </strong>We conducted a multi-institutional retrospective study of 910 standard, 409 Retzius-sparing, and 272 hood RARP during February 2012-September 2025. Standard and hood techniques used 18Fr urethral catheters, and the Retzius-sparing technique used 18Fr suprapubic catheters. The primary end point was cystoscopically confirmed VUAS requiring intervention within 12 months. Urinary continence was assessed using the validated Expanded Prostate Cancer Index Composite for Clinical Practice (EPIC-CP). Multivariable logistic regression assessed factors associated with VUAS.</p><p><strong>Results: </strong>There were 19 VUASs overall, with an incidence of 1.6%, 1.5%, and 0% after standard, hood, and Retzius-sparing techniques, respectively. In 88.2%, VUAS resolved with a single endoscopic incision or dilation followed by 6 months of intermittent self-catheterization, without worsening urinary continence (<i>P</i> = .317). In adjusted analyses, Retzius-sparing vs standard RARP was associated with lower odds of VUAS (odds ratio [OR] 0.051; 95% confidence interval [CI] 0.003 to 0.870; <i>P</i> = .040). Diabetes was associated with almost three-fold higher odds of VUAS (OR 2.974; 95% CI 1.146-7.721; <i>P</i> = .025). Increasing surgeon experience was associated with fewer VUASs (OR 0.998; 95% CI 0.995-1.000; <i>P</i> = .046).</p><p><strong>Conclusions: </strong>There were no VUAS after Retzius-sparing RARP, and Retzius-sparing vs standard approach was associated with lower odds of stenosis. Endoscopic management with structured self-catheterization achieved high success without worsening incontinence. Prospective studies are needed to validate our findings.</p>","PeriodicalId":74033,"journal":{"name":"JU open plus","volume":"4 6","pages":"e00060"},"PeriodicalIF":0.0,"publicationDate":"2026-06-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13308636/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148347574","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Variations in Urinary Microbiota on a Short-Duration Space Mission to the International Space Station.","authors":"Paul H Chung, Ben Boursi, Harel Baris, Joon Yau Leong, J Curtis Nickel, Emanuele Chisari, Javad Parvizi, Craig D Tipton, Jacob Ancira, Aaron Hochberg, Jack Rifkin, Caleb D Phillips","doi":"10.1097/JU9.0000000000000409","DOIUrl":"10.1097/JU9.0000000000000409","url":null,"abstract":"<p><strong>Introduction: </strong>Space travel exposes crew to substantial stressors, which may potentially alter their microbiome and be detrimental to their health and safety. We hypothesize that urinary microbiota is altered during a short-duration spaceflight to the International Space Station (ISS).</p><p><strong>Methods: </strong>Urine samples were collected from 4 male crew members. One crew member provided samples while on orbit on the ISS using a urine collection kit (UCK) designed for low-gravity environments. This crew member also provided paired mid-stream and UCK samples on Earth prelaunch and on return for direct comparison of collection methods. Three additional crew members provided mid-stream samples prelaunch and on return, and also for follow-up timepoints to serve as ex post facto control samples. Urine was stored at -80℃ and sent for 16s next-generation sequencing (MicroGenDX, Lubbock, TX).</p><p><strong>Results: </strong>Bacterial load (<i>P</i> = .52), species richness (<i>P</i> = .64), and differences in microbiota composition (<i>P</i> = .26) did not significantly vary by the collection method (mid-stream vs UCK). Significant differences in species richness, load, and microbial composition among preflight, orbital, and return mission samples were detected (<i>P</i> = .047, F = 1.8092, df = 2.9, R2 = 0.34076). Orbital microbial composition significantly differed from preflight (<i>P</i> = .03) and return (<i>P</i> = .03), whereas preflight and return samples did not differ (<i>P</i> > .05). Comparison with the limited follow-up ex post facto Earth-bound samples serving as controls showed no significant differences among preflight or return mission samples, but preflight (<i>P</i> = .04) and return (<i>P</i> = .05) did significantly differ compositionally from orbital samples. Continuous temporal effects on composition were evaluated through which bacterial load (<i>P</i> = .05) was statistically significant, peaking during the orbital period.</p><p><strong>Conclusions: </strong>Results are consistent with an effect of space travel altering the urinary microbiota. Further studies are needed to confirm this result and to better understand whether such changes may be detrimental to the health and safety of space travelers and professional astronauts.</p>","PeriodicalId":74033,"journal":{"name":"JU open plus","volume":"4 2","pages":"e00017"},"PeriodicalIF":0.0,"publicationDate":"2026-02-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12911487/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146222289","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Combining Serum Prostate Health Index With Urinary PCA3 and TMPRSS2:ERG RNA Testing Improves Detection of Clinically Significant Prostate Cancer.","authors":"Nicholas W Eyrich, Yijian Huang, Yingye Zheng, John Wei, Lori Sokoll, Daniel W Chan, Dattatraya Patil, Arul Chinnaiyan, Scott A Tomlins, Yair Lotan, Daniel Lin, Douglas Scherr, Yanqing Wang, Adam Kibel, Samir S Taneja, Mohamed Bidair, Ian M Thompson, Martin G Sanda, Vikram M Narayan","doi":"10.1097/JU9.0000000000000425","DOIUrl":"10.1097/JU9.0000000000000425","url":null,"abstract":"<p><strong>Purpose: </strong>We sought to determine whether combining prostate health index (Phi) with urinary prostate cancer antigen 3 (PCA3) and TMPRSS2:ERG (T2:ERG) could improve selection of men for prostate biopsy. These biomarkers have been validated in prostate cancer (PCa) detection separately, but their combination has not previously been developed.</p><p><strong>Materials and methods: </strong>Prebiopsy blood and post-digital rectal examination urine specimens were assayed to predict subsequent biopsy outcomes from training and validation cohorts (1073 participants across 11 academic centers). Clinical algorithms for combining Phi and PCA3-T2:ERG to predict Grade Group ≥ 2 (GG ≥ 2) PCa were formulated using the training cohort (N = 512). Prediction rules and hypotheses were locked before validation using biopsy-naïve men from the NCI Early Detection Research Network urinary PCA3 trial (N = 561). Rules were compared in weighted sum of specificity and sensitivity with weights specified a priori, and <i>P</i> values were obtained through bootstrap in the validation study.</p><p><strong>Results: </strong>Primary validation analysis showed that Phi combined with urinary PCA3 outperformed Phi alone (<i>P</i> = .002). Furthermore, serum Phi combined with urinary PCA3-T2:ERG outperformed urinary PCA3-T2:ERG in each of the 3 algorithms reflecting different potential clinical workflows: (1) serum Phi and urine PCA3-T2:ERG tested simultaneously, either exceeding its own threshold (<i>P</i> = .04); (2) urine PCA3-T2:ERG first and those in the grey zone resolved by subsequent serum Phi (<i>P</i> = .03); and (3) serum Phi first and those in the grey zone resolved by subsequent urine PCA3-T2:ERG (<i>P</i> = .002).</p><p><strong>Conclusions: </strong>Combining serum Phi with urinary PCA3 RNA alone or together with urinary T2:ERG RNA, simultaneously or sequentially, improves selection of men for initial prostate biopsy and represents an avenue to improve early detection of aggressive PCa.</p>","PeriodicalId":74033,"journal":{"name":"JU open plus","volume":"4 2","pages":"e00019"},"PeriodicalIF":0.0,"publicationDate":"2026-02-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12911490/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146222304","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}