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Validation of a Urine-Based Proteomics Test to Predict Clinically Significant Prostate Cancer: Complementing mpMRI

Maria Frantzi1, Ana C Morillo2, Guillermo Lendinez3

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Pathobiology : Journal of Immunopathology, Molecular and Cellular Biology
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Summary

A new 19-biomarker model (19-BM) accurately predicts clinically significant prostate cancer (csPCa) in biopsy-naive men. This test, when combined with MRI, improves diagnostic accuracy and can reduce unnecessary biopsies.

Keywords:
BiomarkerMultiparametric magnetic resonance imagingProstate cancerProteomicsUrine

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Area of Science:

  • Urology
  • Oncology
  • Proteomics

Background:

  • Prostate cancer (PCa) is the most common cancer in men, necessitating accurate prediction of clinically significant PCa (csPCa).
  • A previously developed 19-biomarker model (19-BM) using capillary electrophoresis-mass spectrometry (CE-MS) showed promise.
  • This study aimed to validate the 19-BM in a prospective, multicenter cohort of biopsy-naive patients.

Purpose of the Study:

  • To validate the diagnostic performance of the 19-biomarker model (19-BM) for predicting clinically significant prostate cancer (csPCa).
  • To compare the accuracy of 19-BM against prostate-specific antigen (PSA) and PSA density.
  • To evaluate the added value of integrating 19-BM with multiparametric magnetic resonance imaging (mpMRI).

Main Methods:

  • Urine samples from 101 biopsy-naive patients were analyzed using CE-MS.
  • The 19-BM score was calculated using support vector machine-based software.
  • All patients underwent mpMRI, and diagnostic nomograms were explored in conjunction with mpMRI.

Main Results:

  • The 19-BM achieved an AUC of 0.81, outperforming PSA (AUC:0.56) and PSA density (AUC:0.69).
  • In patients with PI-RADS ≤3, 19-BM demonstrated 86% sensitivity and 88% specificity.
  • Integrating 19-BM with mpMRI significantly improved accuracy (AUC:0.90) compared to individual methods.

Conclusions:

  • The 19-BM shows favorable reproducibility for predicting csPCa.
  • 19-BM effectively identified insignificant PCa in patients with PI-RADS ≤3, minimizing missed csPCa cases.
  • The 19-BM test can complement mpMRI, potentially reducing the need for invasive biopsies.