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Assessment of Serum microRNA Biomarkers to Predict Reclassification of Prostate Cancer in Patients on Active Surveillance
- Source :
- Journal of Urology. 199:1475-1481
- Publication Year :
- 2018
- Publisher :
- Ovid Technologies (Wolters Kluwer Health), 2018.
-
Abstract
- Conventional clinical variables cannot accurately differentiate indolent from aggressive prostate cancer in patients on active surveillance. We investigated promising circulating miRNA biomarkers to predict the reclassification of active surveillance cases.We collected serum samples from 2 independent active surveillance cohorts of 196 and 133 patients for the training and validation, respectively, of candidate miRNAs. All patients were treatment naïve and diagnosed with Gleason score 6 prostate cancer. Samples were collected prior to potential reclassification. We analyzed 9 circulating miRNAs previously shown to be associated with prostate cancer progression. Logistic regression and ROC analyses were performed to assess the predictive ability of miRNAs and clinical variables.A 3-miR (miRNA-223, miRNA-24 and miRNA-375) score was significant to predict patient reclassification (training OR 2.72, 95% CI 1.50-4.94 and validation OR 3.70, 95% CI 1.29-10.6). It was independent of clinical characteristics in multivariable models. The ROC AUC was maximized when combining the 3-miR score and prostate specific antigen, indicating additive predictive value. The 3-miR score plus the prostate specific antigen panel cutoff achieved 89% to 90% negative predictive value and 66% to 81% specificity.The 3-miR score combined with prostate specific antigen represents a noninvasive biomarker panel with high negative predictive value. It may be used to identify patients on active surveillance who have truly indolent prostate cancer.
- Subjects :
- Male
Oncology
medicine.medical_specialty
Biopsy
Urology
medicine.medical_treatment
030232 urology & nephrology
Logistic regression
Gleason Score 6
03 medical and health sciences
Prostate cancer
0302 clinical medicine
Predictive Value of Tests
Internal medicine
Biomarkers, Tumor
medicine
Humans
In patient
Circulating MicroRNA
Prospective Studies
Watchful Waiting
Serum microrna
Aged
Retrospective Studies
Aged, 80 and over
business.industry
Prostate
Prostatic Neoplasms
Middle Aged
medicine.disease
Prostate-specific antigen
ROC Curve
030220 oncology & carcinogenesis
Predictive value of tests
Disease Progression
Feasibility Studies
Neoplasm Grading
business
Watchful waiting
Subjects
Details
- ISSN :
- 15273792 and 00225347
- Volume :
- 199
- Database :
- OpenAIRE
- Journal :
- Journal of Urology
- Accession number :
- edsair.doi.dedup.....8f8f17d872042f46cae9219644bf11e2