Urinary Amino Acid Profiling as a Non-invasive Diagnostic and Risk Stratification Tool in Prostate Cancer.

Area of Science:

• Urology
• Metabolomics
• Oncology

Background:

• Prostate cancer (PCa) is a leading male malignancy.
• Prostate-specific antigen (PSA) testing has limited specificity, leading to unnecessary biopsies.
• Urinary metabolomic profiling offers a non-invasive method to detect PCa-related metabolic changes.

Purpose of the Study:

• To evaluate urinary amino acid concentrations for differentiating PCa from benign conditions.
• To assess the potential of amino acids in identifying high-risk PCa.
• To determine if amino acid levels provide diagnostic information independent of prostate volume or prior manipulation.

Main Methods:

• Collected first-morning urine samples from 90 men (60 PCa, 30 controls) without prior prostate manipulation.
• Quantified total urinary amino acids using high-performance liquid chromatography.
• Analyzed associations between amino acid concentrations and PCa, risk factors, and clinical parameters.

Main Results:

• Significant alterations in glutamate+glutamine, arginine, leucine, and methionine were observed in PCa patients.
• Leucine demonstrated high discriminatory performance (AUC=0.79).
• Combining urinary amino acids with PSA significantly improved diagnostic accuracy.
• Specific amino acids (serine, histidine) correlated with disease characteristics like node-positivity and high-risk status.

Conclusions:

• Urinary amino acid profiling is a promising non-invasive adjunct to PSA testing for PCa diagnosis.
• This approach may enhance diagnostic specificity, especially for men with borderline PSA levels.
• Patient-friendly urine sampling without prior manipulation increases outpatient applicability, warranting multi-center validation.