The malignancy index in plasma samples as a prostate cancer biomarker

No unambiguous role of the involvement of uroplasminogen activator (uPA) and plasminogen activator inhibitor type-1 (PAI-1) in prostate cancer has emerged, with current evidence suggesting that neither biomarker is likely of significant clinical value, save as an overall contributor. In this study, we attempt to discriminate prostate cancer from non-cancer in a cohort of plasma samples, using the Imubind ELISA assay. In this cohort, PAI-1 levels are higher in prostate cancer patients than healthy donors; uPA levels are higher in healthy donors than prostate cancer patients; and the uPA/PAI-1 ratio is higher in healthy donors than in prostate cancer patients. To date, and across three prostate sample types, i.e. transurethral resection tissue, needle biopsies, and blood plasma, data have been disparate. Given the inconsistency, a malignancy index was created by dividing the product of three biomarkers [uPA, PAI-1, and prostate specific antigen (PSA)] by the age of the patient/donor. The malignancy index clearly distinguishes prostate disease from non-disease in peripheral blood plasma samples (P=0.0127), concurring with findings in core needle biopsies and transurethral resection tissue, reported elsewhere. This is an important finding given the gravity of prostate cancer and the legions of over-diagnosed and over-treated men worldwide.