(HealthDay News) — Urine-derived extracellular vesicle RNA can provide diagnostic information for aggressive prostate cancer prior to biopsy as well as prognostic information for men under active surveillance for prostate cancer, according to a study published online in BJU International.

Shea P. Connell, PhD, from Norwich Medical School at the University of East Anglia in the United Kingdom, and colleagues developed a risk classifier using urine-derived extracellular vesicle RNA expression profiles for prostate cancer. Four prostate urine risk (PUR) signatures were generated to predict the probability of normal tissue, D’Amico low-risk, intermediate-risk, and high-risk (PUR-1, PUR-2, PUR-3, and PUR-4, respectively) prostate cancer. The model was applied to 177 men for diagnostic evaluation and, in an active surveillance (AS) cohort, to 87 men for prognostic evaluation.

The researchers observed a significant correlation for each PUR signature with its corresponding clinical category. The presence of clinically significant intermediate-risk or high-risk disease was predicted by PUR-4 status with an area under the receiver operating characteristic curve of 0.77. PUR application provided a net benefit over current clinical practice. In the AS cohort, definition by PUR status and proportion of PUR-4 were significantly associated with time to progression (interquartile range hazard ratio, 2.86). When utilized continuously, PUR-4 dichotomized patient groups with differential progression rates of 10 and 60% at 5 years after urine collection (hazard ratio, 8.23).

“Our urine test could be used to not only diagnose prostate cancer without the need for an invasive needle biopsy but to identify a patient’s level of risk,” one coauthor said in a statement.

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Connell SP, Hanna M, McCarthy F, et al. A four‐group urine risk classifier for predicting outcomes in patients with prostate cancer. BJU Intl.

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