title: TMPRSS2-ERG fusion transcripts expression in patients referred for prostate biopsy: combining detection in urine and needle rinse material.
abstract: OBJECTIVE
  The objective of this study was to combine urine and prostate biopsy rinse material (BRM) assays to increase sensitivity for fusion gene detection.
  
  
  METHODS
  A total of 194 patients with suspicion of prostate cancer were prospectively included. Urine samples were collected before or after prostate biopsy, as well as BRM. RT-qPCR was used for the detection of fusion transcripts. A microfocal cancer on biopsy was defined by a single core involved with less than 3 mm of Gleason score 3 + 3 cancer. The association between RT-qPCR and biopsy results was statistically assessed.
  
  
  RESULTS
  Seven patients were excluded because of insufficient material. Cancer was detected on biopsy in 100 (53%) patients. Urine alone, BRM alone and both samples were obtained in 155, 164 and 132 patients, respectively. In patients with evidence of cancer on biopsy, a fusion transcript was detected in 63, 55 and 73% of the cases on urine alone, BRM alone and paired samples, respectively. Fusion gene detection on BRM was only associated with the amount of cancer on biopsy. Urine fusion score had a larger area under the curve than serum PSA (p = 0.002) and was significantly higher in patients with high Gleason score and significant cancer on biopsy. Assays of paired samples allowed increasing sensitivity in all subgroups of patients.
  
  
  CONCLUSIONS
  TMPRSS2-ERG fusion gene detection may be performed both in the urine and BRM to increase sensitivity. However, only T-E urine score was associated with adverse pathological features.
authors.affiliation: Department of Urology, Hôpital Cochin, Assistance Publique-Hôpitaux de Paris, 27 rue du Faubourg Saint Jacques, 75014, Paris, France, nicolasbdl@hotmail.com.
authors.forename: Nicolas Barry
authors.initials: NB
authors.lastname: Delongchamps
authors.forename: Patrick
authors.initials: P
authors.lastname: Younes
authors.forename: Lydie
authors.initials: L
authors.lastname: Denjean
authors.forename: Marc
authors.initials: M
authors.lastname: Zerbib
authors.forename: Phuong-Nhi
authors.initials: PN
authors.lastname: Bories
mesh_terms: D000368:Aged; D062005:Biopsy, Large-Core Needle; D016022:Case-Control Studies; D015331:Cohort Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D015514:Oncogene Proteins, Fusion / Q000235:genetics* / Q000378:metabolism / Q000652:urine; D011446:Prospective Studies; D011467:Prostate / Q000378:metabolism* / Q000473:pathology; D011471:Prostatic Neoplasms / Q000175:diagnosis / Q000235:genetics*; D012333:RNA, Messenger / Q000378:metabolism* / Q000652:urine; D020133:Reverse Transcriptase Polymerase Chain Reaction; D012680:Sensitivity and Specificity
chemical_list: D015514:Oncogene Proteins, Fusion; D012333:RNA, Messenger; C515553:TMPRSS2-ERG fusion protein, human