Plasma Sarcosine Measured by Gas Chromatography-Mass Spectrometry Distinguishes Prostatic Intraepithelial Neoplasia and Prostate Cancer from Benign Prostate Hyperplasia

Abstract

Objective Sarcosine was postulated in 2009 as a biomarker for prostate cancer (PCa). Here, we assess plasma sarcosine as a biomarker that is complementary to prostate-specific antigen (PSA). Methods Plasma sarcosine was measured using gas chromatography-mass spectrometry (GC-MS) in adults classified as noncancerous controls (with benign prostate hyperplasia [BPH], n = 36), with prostatic intraepithelial neoplasia (PIN, n = 16), or with PCa (n = 27). Diagnostic accuracy was assessed using receiver operating characteristic curve analysis. Results Plasma sarcosine levels were higher in the PCa (2.0 µM [1.3–3.3 µM], P <.01) and the PIN (1.9 µM [1.2–6.5 µM], P <.001) groups than in the BPH (0.9 µM [0.6–1.4 µM]) group. Plasma sarcosine had “good” and “very good” discriminative capability to detect PIN (area under the curve [AUC], 0.734) and PCa (AUC, 0.833) versus BPH, respectively. The use of PSA and sarcosine together improved the overall diagnostic accuracy to detect PIN and PCa versus BPH. Conclusion Plasma sarcosine measured by GC-MS had “good” and “very good” classification performance for distinguishing PIN and PCa, respectively, relative to noncancerous patients diagnosed with BPH.

Combining Magnetic Resonance Diffusion-Weighted Imaging with Prostate-Specific Antigen to Differentiate Between Malignant and Benign Prostate Lesions

“…Similarly, Kazuno et al reported the serum O-glycosylated clusterin level could be a complementary indicator for the malignancy PCa, when PSA values were measured at less than 10 ng/mL [ 20 ]. Furthermore, Markin et al discovered plasma sarcosine had “very good” classification performance (AUC, 0.833) for distinguishing PCa from BPH, and the use of PSA and sarcosine together increased the overall diagnostic accuracy [ 21 ]. In the future, we may find more effective tumor makers to improve the diagnostic capability for detecting PCa.…”

Metabolic Rewiring and the Characterization of Oncometabolites

“…In contrast to early reports, a Norwegian study of 3000 prostate cancer cases and 3000 controls found that men with a high serum sarcosine concentration were at a modestly reduced prostate cancer risk [84]. Considering the most recent evaluations of sarcosine [85,86], it is best considered as a biomarker for prostate cancer, especially when combined with other biomarkers such as prostate-specific antigen (PSA). According to these findings, sarcosine does not appear to possess the hallmarks of an oncometabolite.…”

Nanoreactor of sarcosine oxidase-embedded ZIFs activates fluorescent response for diagnosis of prostate cancer

“…Sarcosine, as known as an N-methyl derivative of the amino acid glycine, is a biomarker for PCa, which could increase greatly during the progression of PCa to metastasis. 6 A wide variety of techniques have been applied for the quantitative determination of sarcosine, including mass spectrometry (MS)based methods 7,8 and electrochemical detection. 9 Owing to their high accuracy and sensitivity, these methods are used in many fields, and have even become authoritative detection methods.…”