title: Quadriplex model enhances urine-based detection of prostate cancer.
abstract: BACKGROUND
  The major advantages of urine-based assays are their non-invasive character and ability to monitor prostate cancer (CaP) with heterogeneous foci. While the test for the prostate cancer antigen 3 (PCA3) is commercially available, the aim of our research was to test other putative urine markers in multiplex settings (AMACR (α-methylacyl-CoA racemase), EZH2 (enhancer of zeste homolog 2), GOLM1 (golgi membrane protein 1), MSMB (microseminoprotein, β), SPINK1 (serine peptidase inhibitor) and TRPM8 (transient receptor potential cation channel, subfamily M, member 8)).
  
  
  METHODS
  Expression of the candidate biomarkers was studied in sedimented urine using quantitative reverse transcriptase polymerase chain reaction in two sets of patients with and without restriction on serum PSA levels.
  
  
  RESULTS
  We confirmed that PCA3 is an independent predictor of cancer in the patients without restriction of serum PSA values (set 1, n=176, PSA=0.1-587 ng ml(-1)). However, AMACR was the only parameter that differentiated CaP from non-CaP patients with serum PSA between 3 and 15 ng ml(-1) (set 2, n=104). The area under curve (AUC) for this gene was 0.645 with both sensitivity and specificity at 65%. Further improvement was achieved by multivariate logistic regression analysis, which identified novel duplex (TRPM8 and MSMB), triplex (plus AMACR) and quadriplex (plus PCA3) models for the detection of early CaPs (AUC=0.665, 0.726 and 0.741, respectively).
  
  
  CONCLUSIONS
  Novel quadriplex test could be implemented as an adjunct to serum PSA or urine PCA3 and this could improve decision making for diagnostics in the case of 'PSA dilemma' patients.
authors.affiliation: Department of Clinical and Molecular Pathology, Laboratory of Molecular Pathology, Institute of Molecular and Translational Medicine, Palacky University and University Hospital, Olomouc, Czech Republic.
authors.forename: T
authors.initials: T
authors.lastname: Jamaspishvili
authors.forename: M
authors.initials: M
authors.lastname: Kral
authors.forename: I
authors.initials: I
authors.lastname: Khomeriki
authors.forename: V
authors.initials: V
authors.lastname: Vyhnankova
authors.forename: G
authors.initials: G
authors.lastname: Mgebrishvili
authors.forename: V
authors.initials: V
authors.lastname: Student
authors.forename: Z
authors.initials: Z
authors.lastname: Kolar
authors.forename: J
authors.initials: J
authors.lastname: Bouchal
mesh_terms: D000328:Adult; D000368:Aged; D000951:Antigens, Neoplasm / Q000652:urine; D014408:Biomarkers, Tumor / Q000235:genetics / Q000652:urine*; D055088:Early Detection of Cancer; D006801:Humans; D008297:Male; D008875:Middle Aged; D015233:Models, Statistical; D017430:Prostate-Specific Antigen / Q000097:blood; D011471:Prostatic Neoplasms / Q000175:diagnosis* / Q000235:genetics / Q000652:urine; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity
chemical_list: D000951:Antigens, Neoplasm; D014408:Biomarkers, Tumor; D017430:Prostate-Specific Antigen