title: Urine TMPRSS2:ERG fusion transcript integrated with PCA3 score, genotyping, and biological features are correlated to the results of prostatic biopsies in men at risk of prostate cancer.
abstract: BACKGROUND
  Detection of fusion gene TMPRSS2:ERG transcripts in urine have been recently described in order to refine urine-based detection of prostate cancer (PCa), but data its clinical impact remain scarce. We aimed at investigating the correlation of TMPRSS2:ERG, prostate cancer antigen 3 (PCA3), prostate specific antigen (PSA) density, genetic variants, and androgenic status with outcome and pathological findings at prostatic biopsy.
  
  
  METHODS
  Between 2007 and 2011, 291 patients at risk of PCa because of PSA > 3.0 ng/ml (55%) or candidate to active surveillance protocol justifying restaging biopsy management (45%) were recruited. TMPRSS2:ERG was detected by urine assay (Progensa™). PCA3-score, PSA level, bioavailable testosterone level, prostate volume, rs1447295 and rs6983267 genotypes were prospectively assessed. Univariate and multivariate analysis by logistic regression model (logit) were conducted to study the correlation of TMPRSS2:ERG status, PCA3, and PSA density with biopsy results, and Gleason score.
  
  
  RESULTS
  Of 291 patients, 173 had PCa and 118 had negative biopsy. PCA3 score, PSA density and TMPRSS2:ERG-score were correlated with presence of PCa (P < 0.0001, P = 0.046, and P < 0.0001, respectively). This correlation remained strong on multivariable analysis model (area under curve 0.743). PCA3 score and PSA density were significantly associated with presence of Grade 4 through multivariable analysis. PCA3 score was also correlated to the percentage of positive cores at biopsy (P = 0.008).
  
  
  CONCLUSIONS
  Integration of levels TMPRSS2:ERG transcripts in urine, with PCA3-score, androgenic status, genetic status and traditional clinical variables could significantly increase detection of high risk localized PCa.
authors: Department of Urology, Tenon Hospital, University Paris, Assistance Publique-Hopitaux de Paris, France. cornu@hotmail.fr
authors: Jean-Nicolas
authors: JN
authors: Cornu
authors: Géraldine
authors: G
authors: Cancel-Tassin
authors: Christophe
authors: C
authors: Egrot
authors: Cécile
authors: C
authors: Gaffory
authors: François
authors: F
authors: Haab
authors: Olivier
authors: O
authors: Cussenot
mesh_terms: D000368:Aged; D000951:Antigens, Neoplasm / Q000097:blood*; D014408:Biomarkers, Tumor / Q000235:genetics / Q000378:metabolism*; D001706:Biopsy; D050939:Gene Fusion; D005838:Genotype; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D011446:Prospective Studies; D011467:Prostate / Q000473:pathology*; D011471:Prostatic Neoplasms / Q000175:diagnosis / Q000453:epidemiology* / Q000235:genetics; D012189:Retrospective Studies; D012307:Risk Factors; D012680:Sensitivity and Specificity; D012697:Serine Endopeptidases / Q000235:genetics / Q000652:urine*; D015534:Trans-Activators / Q000235:genetics / Q000652:urine*; D014158:Transcription, Genetic / Q000235:genetics; D000071230:Transcriptional Regulator ERG
chemical_list: D000951:Antigens, Neoplasm; D014408:Biomarkers, Tumor; C072312:ERG protein, human; D015534:Trans-Activators; D000071230:Transcriptional Regulator ERG; C479341:prostate cancer antigen 3, human; D012697:Serine Endopeptidases; C421305:TMPRSS2 protein, human