2121 URINE MEASUREMENT OF TMPRSS2:ERG FOR THE EARLY DETECTION OF SIGNIFICANT PROSTATE CANCER (2010)

You have accessJournal of UrologyProstate Cancer: Markers II1 Apr 20102121 URINE MEASUREMENT OF TMPRSS2:ERG FOR THE EARLY DETECTION OF SIGNIFICANT PROSTATE CANCER Kyoko Sakamoto, Sheila Aubin, Scott Tomlins, Christopher Kane, Tracy Downs, Jonathan Silberstein, Javed Siddiqui, Yvonne Penabella, Yves Fradet, Harry Rittenhouse, Jack Groskopf, and Arul Chinnaiyan Kyoko SakamotoKyoko Sakamoto San Diego, CA More articles by this author , Sheila AubinSheila Aubin San Diego, CA More articles by this author , Scott TomlinsScott Tomlins Ann Arbor, MI More articles by this author , Christopher KaneChristopher Kane San Diego, CA More articles by this author , Tracy DownsTracy Downs San Diego, CA More articles by this author , Jonathan SilbersteinJonathan Silberstein San Diego, CA More articles by this author , Javed SiddiquiJaved Siddiqui Ann Arbor, MI More articles by this author , Yvonne PenabellaYvonne Penabella San Diego, CA More articles by this author , Yves FradetYves Fradet Quebec, Canada More articles by this author , Harry RittenhouseHarry Rittenhouse San Diego, CA More articles by this author , Jack GroskopfJack Groskopf San Diego, CA More articles by this author , and Arul ChinnaiyanArul Chinnaiyan Ann Arbor, MI More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2010.02.2209AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Serum prostate specific antigen (sPSA) is widely used for the early detection of prostate cancer (CaP), despite a well-characterized lack of specificity and an unclear effect on mortality. Here we evaluated the expression of TMPRSS2:ERG, a highly specific gene-fusion biomarker, in post digital rectal exam (DRE) urine for the diagnosis of prostate cancer. METHODS Post DRE urine specimens were prospectively collected from 669 men referred for biopsy and/or prostatectomy at three institutions. TMPRSS2:ERG mRNA copies in samples were quantified using a transcription-mediated amplification assay and normalized to PSA mRNA copies then multiplied by 100000 to get a TMPRSS2:ERG score. The prototype TMPRSS2:ERG urine assay detects the gene fusion mRNA isoform TMPRSS2 exon1 to ERG exon4. TMPRSS2:ERG and sPSA clinical performance for predicting biopsy outcome was evaluated through ROC curve analysis. TMPRSS2:ERG score was correlated to prostatectomy Gleason score (GS), tumor volume and prostate weight. RESULTS Urine specimens yielded sufficient mRNA for TMPRSS2:ERG analysis in 635 of 669 patients (94.9%). In both individual and combined biopsy cohorts (n = 572), TMRPSS2:ERG had superior AUC (0.72) compared to sPSA (0.60) or the Prostate Cancer Prevention Trial risk calculator (0.64) for predicting prostate cancer biopsy outcome. Higher TMPRSS2:ERG score was also associated with significant vs. insignificant cancer on biopsy by the Epstein criteria (p = 0.004). In men undergoing prostatectomy (n = 101), higher TMPRSS2:ERG score was associated with upgrading at prostatectomy (biopsy GS 6 to prostatectomy GS 7, p=0.035), high prostatectomy GS (>6 vs. <6, p = 0.002) and large tumor volume (R = 0.24, p = 0.014) but not prostate weight (R = -0.20, p = 0.052). CONCLUSIONS The TMPRSS2:ERG urine test yielded similar clinical performance across multiple subject groups. Importantly, TMPRSS2:ERG scores were associated with prostatectomy GS (regardless of biopsy GS) and with tumor volume, as well as Epstein criteria for significant cancer. These results indicate that the TMPRSS2:ERG urine test may have utility for specifically identifying clinically relevant prostate cancer. © 2010 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 183Issue 4SApril 2010Page: e824 Advertisement Copyright & Permissions© 2010 by American Urological Association Education and Research, Inc.MetricsAuthor Information Kyoko Sakamoto San Diego, CA More articles by this author Sheila Aubin San Diego, CA More articles by this author Scott Tomlins Ann Arbor, MI More articles by this author Christopher Kane San Diego, CA More articles by this author Tracy Downs San Diego, CA More articles by this author Jonathan Silberstein San Diego, CA More articles by this author Javed Siddiqui Ann Arbor, MI More articles by this author Yvonne Penabella San Diego, CA More articles by this author Yves Fradet Quebec, Canada More articles by this author Harry Rittenhouse San Diego, CA More articles by this author Jack Groskopf San Diego, CA More articles by this author Arul Chinnaiyan Ann Arbor, MI More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...