Controversies in using urine samples for Prostate Cancer detection: PSA and PCA3 expression analysis

Area of Science:

• Oncology
• Molecular Diagnostics
• Urology

Background:

• Prostate cancer (PCa) is a leading malignancy worldwide.
• Prostate-Specific Antigen (PSA) is a serum marker for PCa detection but lacks specificity.
• Urinary PCA3 mRNA detection is a potential non-invasive biomarker for PCa.

Purpose of the Study:

• To assess the efficacy of detecting PCA3 mRNA and PSA mRNA in urine without prostate massage.
• To optimize a protocol for urinary gene expression analysis for PCa detection.
• To evaluate alternative methods for non-invasive PCa biomarker assessment.

Main Methods:

• Collected urine samples from 57 patients with suspected prostate disease without prostate massage.
• Extracted RNA using various methods and included a preamplification step.
• Utilized Real-Time PCR for gene detection of PSA mRNA and PCA3 mRNA.

Main Results:

• The TriPure Isolation Reagent increased RNA concentration.
• Only 15.8% of cases showed PSA mRNA expression and 3.8% showed PCA3 mRNA expression.
• A preamplification step did not improve gene detection results.

Conclusions:

• Prostate massage is essential for detecting prostate-specific markers like PSA and PCA3 in urine.
• Facilitating prostate cell passage into the urinary tract is necessary for successful urine-based biomarker detection.
• Current methods without prostate massage limit the diagnostic utility of urinary PCA3 and PSA mRNA.