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Clinically significant Prostate Cancer diagnosed using a urinary molecular biomarker-based risk score: two case reports

BACKGROUND: Identifying men for a repeat prostate biopsy is a conundrum to urologists. Risk calculators (RCs) such as the European Randomized Study of Screening for Prostate Cancer (ERSPC) RCs have been developed to predict the outcome of prostate biopsies and have been shown to improve diagnostic a...

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Autores principales: Minnee, Pieter, Hessels, Daphne, Schalken, Jack A., Van Criekinge, Wim
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2019
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6884880/
https://www.ncbi.nlm.nih.gov/pubmed/31783839
http://dx.doi.org/10.1186/s12894-019-0561-6
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author Minnee, Pieter
Hessels, Daphne
Schalken, Jack A.
Van Criekinge, Wim
author_facet Minnee, Pieter
Hessels, Daphne
Schalken, Jack A.
Van Criekinge, Wim
author_sort Minnee, Pieter
collection PubMed
description BACKGROUND: Identifying men for a repeat prostate biopsy is a conundrum to urologists. Risk calculators (RCs) such as the European Randomized Study of Screening for Prostate Cancer (ERSPC) RCs have been developed to predict the outcome of prostate biopsies and have been shown to improve diagnostic accuracy compared to PSA alone. However, it was recently shown that the outcome for high-grade prostate cancer (PCa) upon biopsy tended to be underestimated in men with previous negative biopsies using ERSPC RC model 4. For these men, an individualized approach combining the clinical information with the outcome of biomarker-related urine tests may help to make a more informed decision. CASE PRESENTATION: Two men, aged 66 and 69 respectively when presented in the clinic, show the typical dilemma of urologist and patient for electing repeat prostate biopsy. Both men had normal DRE findings, did not have a family history of PCa, presented with serum PSA values between 3 and 10 ng/ml and the first biopsies were negative for disease. The ERSPC RC4 did not indicate a biopsy in these men. The urinary molecular biomarker-based test for HOXC6 and DLX1, combining biomarker-expression profiling with clinical risk factors, resulted in SelectMDx Risk scores for these men that were higher than the cut-off of the test. Based on this outcome, mpMRI was performed with an outcome of PI-RADS ≥4 in both men. Histopathological evaluation of TRUS-guided biopsies confirmed high-grade PCa. CONCLUSIONS: The urinary molecular biomarker-based risk score played a pivotal role in the diagnosis of clinically significant PCa whereas ERSPC RC4 outcome would not have indicated further diagnostic follow-up in these two cases. The timely diagnosis was shown to be crucial for the curative treatment by radical retropubic prostatectomy and the potential life-years gained for these two vital males.
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spelling pubmed-68848802019-12-03 Clinically significant Prostate Cancer diagnosed using a urinary molecular biomarker-based risk score: two case reports Minnee, Pieter Hessels, Daphne Schalken, Jack A. Van Criekinge, Wim BMC Urol Case Report BACKGROUND: Identifying men for a repeat prostate biopsy is a conundrum to urologists. Risk calculators (RCs) such as the European Randomized Study of Screening for Prostate Cancer (ERSPC) RCs have been developed to predict the outcome of prostate biopsies and have been shown to improve diagnostic accuracy compared to PSA alone. However, it was recently shown that the outcome for high-grade prostate cancer (PCa) upon biopsy tended to be underestimated in men with previous negative biopsies using ERSPC RC model 4. For these men, an individualized approach combining the clinical information with the outcome of biomarker-related urine tests may help to make a more informed decision. CASE PRESENTATION: Two men, aged 66 and 69 respectively when presented in the clinic, show the typical dilemma of urologist and patient for electing repeat prostate biopsy. Both men had normal DRE findings, did not have a family history of PCa, presented with serum PSA values between 3 and 10 ng/ml and the first biopsies were negative for disease. The ERSPC RC4 did not indicate a biopsy in these men. The urinary molecular biomarker-based test for HOXC6 and DLX1, combining biomarker-expression profiling with clinical risk factors, resulted in SelectMDx Risk scores for these men that were higher than the cut-off of the test. Based on this outcome, mpMRI was performed with an outcome of PI-RADS ≥4 in both men. Histopathological evaluation of TRUS-guided biopsies confirmed high-grade PCa. CONCLUSIONS: The urinary molecular biomarker-based risk score played a pivotal role in the diagnosis of clinically significant PCa whereas ERSPC RC4 outcome would not have indicated further diagnostic follow-up in these two cases. The timely diagnosis was shown to be crucial for the curative treatment by radical retropubic prostatectomy and the potential life-years gained for these two vital males. BioMed Central 2019-11-29 /pmc/articles/PMC6884880/ /pubmed/31783839 http://dx.doi.org/10.1186/s12894-019-0561-6 Text en © The Author(s). 2019 Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.
spellingShingle Case Report
Minnee, Pieter
Hessels, Daphne
Schalken, Jack A.
Van Criekinge, Wim
Clinically significant Prostate Cancer diagnosed using a urinary molecular biomarker-based risk score: two case reports
title Clinically significant Prostate Cancer diagnosed using a urinary molecular biomarker-based risk score: two case reports
title_full Clinically significant Prostate Cancer diagnosed using a urinary molecular biomarker-based risk score: two case reports
title_fullStr Clinically significant Prostate Cancer diagnosed using a urinary molecular biomarker-based risk score: two case reports
title_full_unstemmed Clinically significant Prostate Cancer diagnosed using a urinary molecular biomarker-based risk score: two case reports
title_short Clinically significant Prostate Cancer diagnosed using a urinary molecular biomarker-based risk score: two case reports
title_sort clinically significant prostate cancer diagnosed using a urinary molecular biomarker-based risk score: two case reports
topic Case Report
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6884880/
https://www.ncbi.nlm.nih.gov/pubmed/31783839
http://dx.doi.org/10.1186/s12894-019-0561-6
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