Early detection of prostate cancer local recurrence by urinary prostate-specific antigen

Abstract

Purpose: We assessed the role of urinary prostate-specific antigen (uPSA) in the follow-up of prostate cancer after retropubic radical prostatectomy (RRP) for the early detection of local recurrences. Methods:We recruited 50 patients previously treated for prostate cancer with RRP and who had not experienced a prostatespecific antigen (PSA) recurrence within their first postoperative year into a cross-sectional laboratory assessment and prospective 6-year longitudinal follow-up study. We defined biochemical failure as a serum PSA (sPSA) of 0.3 μg/L or greater. Patients provided blood samples and a 50-mL sample of first-voided urine. We performed Wilcoxon rank-sum and Fisher exact tests for statistical analysis. Results:The median sPSA was 0.13 μg/L. The median uPSA was 0.8 μg/L, and was not significantly different when comparing Gleason scores or pathological stages. Of the 50 patients, 27 initially had a nondetectable sPSA but a detectable uPSA, and 11 patients experienced sPSA failure after 6 years. Six patients had detectable sPSA and uPSA initially. Fifteen patients were negative for both sPSA and uPSA, and 13 remained sPSA-free after 6 years. The odds ratio (OR) of having sPSA failure given a positive uPSA test was 4.5 if sPSA was undetectable, but was reduced to 2.6 if sPSA was detectable. The pooled Mantel-Haenszel OR of 4.2 suggested that a detectable uPSA quadrupled the risk of recurrence, independent of whether sPSA was elevated or not. The sensitivity of uPSA for detecting future sPSA recurrences was 81% and specificity was 45%.Conclusion: Urinary PSA could contribute to an early detection of local recurrences of prostate cancer after a radical prostatectomy. RésuméObjectif : Nous avons évalué le rôle de l'antigène prostatique spécifique (APS) urinaire dans le suivi du cancer de la prostate après prostatectomie radicale rétropubienne (PRR) pour le dépistage précoce de récidives locales. Méthodes :

A graphene oxide-peptide fluorescence sensor for proteolytically active prostate-specific antigen

“…8,17 In this case, further expensive surgical procedures such as biopsies often have to be used for the detection of early prostate cancer. Recently, Bolduc et al 37,38 evaluated the usefulness of urinary PSA in the differential diagnosis of prostate cancer and BPH, and found that the level of urinary PSA was 52.6 ng mL À1 for prostate cancer patients and 123.2 ng mL À1 for the patients with BPH, respectively. By comparing this with the concentration (about 105 ng mL À1 ) of normal urinary PSA, which is much higher than that of normal serum PSA because PSA in prostatic fluid readily comes into urine, 39 they proposed that lower urinary PSA points toward prostate cancer, and urinary PSA may serve as a useful marker in the differential diagnosis of prostate cancer and BPH, especially when serum PSA is between 2.5 ng mL À1 and 10 ng mL À1 .…”

Comparative analysis of prostate‐specific antigen by two‐dimensional gel electrophoresis and capillary electrophoresis

“…Urine is nowadays being considered as an alternative biological fluid to serum in the search for new PCa markers . Thus, we have used purified PSA from 2 mL of urine obtained after digital rectal examination, with a high content of PSA.…”

Biomarkers for the Diagnosis of New and Recurrent Prostate Cancer

“…n Urinary PSA The measurement of PSA in urine has dated back to 1985 [17] and has since been studied as a potential biomarker for CaP. Studies have shown the clinical utility of urinary PSA by itself or in conjunction with serum PSA for diagnosing CaP and predicting disease recurrence [18][19][20][21]. The clinical utility of the urine:serum PSA ratio was demonstrated in a prospective multicenter study that showed that urine PSA alone did not distinguish CaP and BPH, but when evaluated as a ratio with serum PSA, it did demonstrate significant differences, with receiver operating characteristic area under the curves (AUC) improving from 0.55 for total PSA and 0.60 for the fPSA:PSA ratio to 0.63 for the urine:serum PSA ratio [19].…”