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Review
. 2019 Sep;22(3):362-381.
doi: 10.1038/s41391-019-0127-4. Epub 2019 Jan 17.

Approaches to urinary detection of prostate cancer

Jillian N Eskra  1 , Daniel Rabizadeh  1 , Christian P Pavlovich  1 , William J Catalona  2 , Jun Luo  3
Affiliations
Review

Approaches to urinary detection of prostate cancer

Jillian N Eskra et al. Prostate Cancer Prostatic Dis. 2019 Sep.

Abstract

Background: Prostate cancer is the most common cancer in American men that ranges from low risk states amenable to active surveillance to high-risk states that can be lethal especially if untreated. There is a critical need to develop relatively non-invasive and clinically useful methods for screening, detection, prognosis, disease monitoring, and prediction of treatment efficacy. In this review, we focus on important advances as well as future efforts needed to drive clinical innovation in this area of urine biomarker research for prostate cancer detection and prognostication.

Methods: We provide a review of current literature on urinary biomarkers for prostate cancer. We evaluate the strengths and limitations of a variety of approaches that vary in sampling strategies and targets measured; discuss reported urine tests for prostate cancer with respect to their technical, analytical, and clinical parameters; and provide our perspectives on critical considerations in approaches to developing a urine-based test for prostate cancer.

Results: There has been an extensive history of exploring urine as a source of biomarkers for prostate cancer that has resulted in a variety of urine tests that are in current clinical use. Importantly, at least three tests have demonstrated high sensitivity (~90%) and negative predictive value (~95%) for clinically significant tumors; however, there has not been widespread adoption of these tests.

Conclusions: Conceptual and methodological advances in the field will help to drive the development of novel urinary tests that in turn may lead to a shift in the clinical paradigm for prostate cancer diagnosis and management.

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Conflict of interest statement

Conflict of interest

WJC is a consultant/advisory board member for Beckman Coulter and has received commercial research support from Beckman Coulter, DeCode Genetics, and Ohmx. JL, CPP, JNE and DR declare no conflict of interest.

Figures

Figure 1.
Figure 1.
Analytical approaches associated with the various fractions of urine following centrifugation.
Figure 2.
Figure 2.
Prostatic components detectable in urine.
Figure 3.
Figure 3.
Future urine tests could be used to guide clinical decision making in detection and management of prostate cancer.
Figure 4.
Figure 4.
Strengths and limitations of the various approaches to urinary biomarker detection.
See this image and copyright information in PMC

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