title: TMPRSS2-ERG fusion transcripts in matched urine and needle rinse material after biopsy for the detection of prostate cancer.
abstract: BACKGROUND
  Current methods for detecting TMPRSS2-ERG fusion transcript in the urine of patients with suspected prostate cancer lack diagnostic sensitivity. We combined urine and prostate biopsy rinse material (BRM) assays to improve the fusion gene detection rate.
  
  
  METHODS
  Eighty patients with clinical and/or prostate-specific antigen suspicion of prostate cancer were prospectively included in the study. Urine samples were collected before and after prostate biopsy, and BRM was collected from the biopsy needle. We used reverse-transcription PCR (RT-PCR) for the detection of fusion transcripts. Microfocal cancer (MFC) on biopsy was defined by a single core involved with ≤3 mm of cancer with Gleason score 3 + 3. We statistically assessed the association between RT-PCR and biopsy results.
  
  
  RESULTS
  Urine alone, BRM alone, and both samples were obtained in 4, 19, and 57 patients, respectively. Three patients were excluded because of insufficient material. In the remaining 77 patients, cancer was detected on biopsy in 42 (55%). The diagnostic sensitivity of the assay for cancer detection was 62% (95% CI 47%-78%), 69% (53%-85%), and 89% (73%-99%) with BRM alone, urine alone, and paired samples, respectively. The lowest values were obtained with the urine assay in patients with MFC or Gleason score >3 + 3 cancer. Assays of paired samples provided increased diagnostic sensitivity in all subgroups of patients.
  
  
  CONCLUSIONS
  TMPRSS2-ERG fusion gene detection may be improved by performing assays in both urine and BRM. Insufficient cell numbers in urine samples and cell lysis during centrifugation may explain the low diagnostic sensitivity of the urine assay.
authors.affiliation: Laboratoire de Biochimie, Groupe Hospitalier Cochin-Broca-Hôtel-Dieu, Hôpital Cochin, 27 Rue du Faubourg Saint-Jacques, 75679 Paris Cedex 14, France. phuong-nhi.bories@cch.aphp.fr
authors.forename: Phuong-Nhi
authors.initials: PN
authors.lastname: Bories
authors.forename: Patrick
authors.initials: P
authors.lastname: Younes
authors.forename: Marc
authors.initials: M
authors.lastname: Zerbib
authors.forename: Lydie
authors.initials: L
authors.lastname: Denjean
authors.forename: Theodora
authors.initials: T
authors.lastname: Popovici
authors.forename: Luc
authors.initials: L
authors.lastname: Cynober
authors.forename: Nicolas Barry
authors.initials: NB
authors.lastname: Delongchamps
mesh_terms: D000368:Aged; D001707:Biopsy, Needle; D006801:Humans; D008297:Male; D008875:Middle Aged; D009339:Needles; D015514:Oncogene Proteins, Fusion / Q000235:genetics*; D011471:Prostatic Neoplasms / Q000175:diagnosis* / Q000473:pathology; D012333:RNA, Messenger / Q000378:metabolism* / Q000652:urine; D020133:Reverse Transcriptase Polymerase Chain Reaction
chemical_list: D015514:Oncogene Proteins, Fusion; D012333:RNA, Messenger; C515553:TMPRSS2-ERG fusion protein, human