title: Measurement of GSTP1 promoter methylation in body fluids may complement PSA screening: a meta-analysis.
abstract: BACKGROUND
  Prostate-specific antigen (PSA) screening has low specificity. Assessment of methylation status in body fluids may complement PSA screening if the test has high specificity.
  
  
  METHODS
  The purpose of this study was to conduct a meta-analysis of the sensitivity and specificity for prostate cancer detection of glutathione-s-transferase-π (GSTP1) methylation in body fluids (plasma, serum, whole blood, urine, ejaculate, and prostatic secretions). We conducted a comprehensive literature search on Medline (Pubmed). We included studies if they met all four of the following criteria: (1) measurement of DNA methylation in body fluids; (2) a case-control or case-only design; (3) publication in an English journal; and (4) adult subjects. Reviewers conducted data extraction independently using a standardised protocol. Twenty-two studies were finally included in this paper. Primer sequences and methylation method in each study were summarised and evaluated using meta-analyses. This paper represents a unique cross-disciplinary approach to molecular epidemiology.
  
  
  RESULTS
  The pooled specificity of GSTP1 promoter methylation measured in plasma, serum, and urine samples from negative-biopsy controls was 0.89 (95% CI, 0.80-0.95). Stratified analyses consistently showed a high specificity across different sample types and methylation methods (include both primer sequences and location). The pooled sensitivity was 0.52 (95% CI, 0.40-0.64).
  
  
  CONCLUSIONS
  The pooled specificity of GSTP1 promoter methylation measures in plasma, serum, and urine was excellent and much higher than the specificity of PSA. The sensitivity of GSTP1 was modest, no higher than that of PSA. These results suggest that measurement of GSTP1 promoter methylation in plasma, serum, or urine samples may complement PSA screening for prostate cancer diagnosis.
authors.affiliation: Division of Epidemiology and Biostatistics, Department of Environmental Health, University of Cincinnati Medical Center, Cincinnati, OH 45267, USA. tianying.wu@uc.edu
authors.forename: T
authors.initials: T
authors.lastname: Wu
authors.forename: E
authors.initials: E
authors.lastname: Giovannucci
authors.forename: J
authors.initials: J
authors.lastname: Welge
authors.forename: P
authors.initials: P
authors.lastname: Mallick
authors.forename: W-Y
authors.initials: WY
authors.lastname: Tang
authors.forename: S-M
authors.initials: SM
authors.lastname: Ho
mesh_terms: D014408:Biomarkers, Tumor / Q000235:genetics; D001826:Body Fluids / Q000737:chemistry; D016022:Case-Control Studies; D019175:DNA Methylation; D017931:DNA Primers; D004273:DNA, Neoplasm / Q000235:genetics; D051549:Glutathione S-Transferase pi / Q000235:genetics*; D006801:Humans; D008297:Male; D016133:Polymerase Chain Reaction; D011401:Promoter Regions, Genetic / Q000235:genetics*; D011467:Prostate / Q000378:metabolism; D017430:Prostate-Specific Antigen / Q000235:genetics*; D011471:Prostatic Neoplasms / Q000175:diagnosis* / Q000235:genetics*; D012680:Sensitivity and Specificity
chemical_list: D014408:Biomarkers, Tumor; D017931:DNA Primers; D004273:DNA, Neoplasm; C496556:GSTP1 protein, human; D051549:Glutathione S-Transferase pi; D017430:Prostate-Specific Antigen