Prostate Cancer: Innovative Urine Test Provides Effective and Accurate Screening Solution

Urinary tract infection, prostatitis, etc.). Conversely, it can be low even in the presence of cancer. Likewise, a “normal” rectal touch does not exclude cancer, as it only allows to detect palpable tumors.

If doubt persists, MRIs and biopsies are made. If prostate cancer is confirmed, its evolution remains difficult to foresee. Some are aggressive and require immediate treatment, while others are slowly evolving, often over more than 15 years. In this case, treatment is not necessary. It is estimated that almost half of the cancers of the prostate detected are of this latent form. However, we do not know how to distinguish the two forms. This implies that many patients undergo superfluous surgery or treatment.

Detect aggressive prostate cancer

This is the raison d'être of the MyProstatesCore 2.0 (MPS2) test. It distinguishes the different grades of cancer, preventing patients with expensive and/or uncomfortable exams and unnecessary treatments.

Prostate cancers are classified according to their Gleason score, between 2 and 10. Its calculation is based on the appearance of cells under the microscope. The first half of the score (noted from 1 to 5) is based on the dominant cellular morphology. The second half (noted from 1 to 5) on the non -dominant cellular motif having the highest grade. Score prostate cancers 3+4 = 7 (Grade II group) or higher are more likely to develop and cause damage than score cancers ≤ 6 (GG I), considered non -aggressive.

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The MPS2 test examines 18 different genes linked to GG II or superior prostate cancer. Researchers have shown that he had a greater diagnostic precision than that of existing biomarkers. “” The use of this test could have saved unnecessary additional tests by imagery or biopsy in completeness in 35 to 51% of patients while maintaining high sensitivity for high -grade cancers that could benefit from early detection “, They underline.

However, in this study which involved some 1,500 men, urine samples had been obtained after a rectal touch. “” The process requires the compression of the prostate, Trainedant the release of cellular debris in L'urine sample that the patient provides after rectal touch “Explains Dr. Ganesh Palapattu, professor of urology and co-author of the study. However, it is obvious that such an examination is uncomfortable and annoying for the patient.

Up to 53 % useless biopsies avoided!

In order to improve the ease of the test, Palapattu and its employees have therefore changed the urine collection method, eliminating prior rectal touch. They then evaluated the precision of the MPS2 test under these new conditions. Their results have just appeared in The Journal of Urology.

Patients provided first urin urine before biopsy. The MPS2 values ​​were calculated using different models, including more or less data: Biomarkers alone (BA; no clinical data), Biomarkers and Clinical Factors (BA+CF), and Biomarkers, Clinical Factors and Volume of volume The prostate (Ba+see+PV). The performance of the MPS2 test and the clinical consequences of the tests have been compared to those of the PSA rate and the Prostate Cancer Prevention Trial Risk Calculator (PCPTRC) – A predictive model developed in 2006 from data of more than 5,500 patients.

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The test cohort included 266 men with a median PSA of 6.6 ng/ml. Biopsies said 103 of them had high -grade cancer. The area under the curve – which reflects the diagnostic test performance – for GG cancer ≥ 2 was 57% for PSA, 62% for PCPTRC and 71%, 74% and 77% for different MPS2 models.

“” As part of a screening approach detecting more than 90% of GG cancers ≥ 2, the MPS2 test would have made it possible to avoid 36 to 42% of unnecessary biopsies, against 13% with the PCPTRC “Report researchers. In addition, in patients who have already undergone a negative biopsy, the MPS2 test would have made it possible to avoid 44 to 53% of repeated biopsies, against only 2.6% with the PCPTRC.

A potential to be confirmed with a wider cohort

Thus, the MPS2 seems to be a practical, versatile and very precise test option to determine the need for MRI or biopsy in patients with high PSA levels. Dr. Palapattu adds that he seems “promising as a home test”.

The results indicate that the test significantly improves the proportion of biopsies avoided compared to the PCPTRC. This, while maintaining a very sensitive detection of Cancer GG ≥ 2. ” The main advantage of this test is that it makes it possible to predict precisely the probability of developing aggressive prostate cancer, which reassures both the patient and the doctor », Note Palapattu. This approach also offers a reduction in health costs, as it is much cheaper than an MRI.

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The team now plans to repeat this study on a larger and more diverse population of men, to confirm the efficiency and precision of the test. She also hopes to study the performance of the test in men as part of a low -risk prostate cancer monitoring screening.

“” The MPS2 could potentially improve the health of our patients by avoiding overdiagnosis and above and allowing us to focus on those who are most likely to have aggressive cancers “Concludes Dr. Palapattu.