Fusion Transcript PCA3 in Urine Predict Prostate Cancer Risk

Urine test for TMPRSS2:ERG and PCA3 levels can predict risk for men with elevated PSA levels

FRIDAY, Aug. 5 (HealthDay News) -- A urine test that detects the presence of a fusion transcript of transmembrane protease, serine 2 (TMPRSS2) and v-ets erythroblastosis virus E26 oncogene homolog (avian) (ERG) genes can predict the risk of prostate cancer in men with elevated serum prostate-specific antigen (PSA), according to a study published in the Aug. 3 issue of Science Translational Medicine.

Scott A. Tomlins, M.D., Ph.D., from the University of Michigan Medical School in Ann Arbor, and colleagues developed a urine test to identify men at the highest risk for clinically significant prostate cancer by detecting the quantitative presence of the fusion transcript TMPRSS2:ERG in 1,312 men with elevated PSA levels who had undergone either a biopsy or prostatectomy. Prospectively collected urine samples were analyzed for the presence of TMPRSS2:ERG and prostate cancer antigen 3 (PCA3), and the men were stratified according to low, intermediate, and high scores.

The investigators found that TMPRSS2:ERG in the urine was linked with clinically significant cancer risk factors at biopsy and prostatectomy, including tumor size and high Gleason score and upgrading of Gleason grade at prostatectomy. When combined with PCA3 levels, TMPRSS2:ERG improved the prediction on of the multivariate Prostate Cancer Prevention Trial risk calculator at the time of biopsy. For men undergoing biopsy, those in the high and low score groups for TMPRSS2:ERG and PCA3 had distinctly different rates of cancer, clinically significant cancer by Epstein criteria, and high-grade cancer on biopsy.

"Urine TMPRSS2:ERG, in combination with urine PCA3, enhances the utility of serum PSA for predicting prostate cancer risk and clinically relevant cancer on biopsy," the authors write.

Several authors are listed as coinventors on a patent on the detection of ETS gene fusions in prostate cancer. Several authors disclosed financial ties to the medical device and biotechnology industries, including Gen-Probe Inc., which partially funded the study.

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