Prostate Cancer Detection by Molecular Urinalysis

Prostate cancer is the most commonly diagnosed cancer and the second leading cause of cancer-related death in the United States. Serum tests for prostate cancer consist essentially of PSA and related isoforms, and when combined with digital rectal examination (DRE) are the mainstays of prostate cancer detection and local staging over the last decade. Recently however, it has become clear that urinary tests for prostate cancer may have a role in prostate cancer detection and prognostication. In this project, we have evaluated the feasibility of detection of prostate cancer by molecular urinalysis, and attempted to develop and validate new biomarkers for prostate cancer and prostatic disease detected on post-DRE urinalyses. Prostatic manipulation from DRE results in the shedding of prostatic material and even whole prostatic cells into the prostatic ducts and urethra: We have demonstrated that there is a cytokine profile associated with the prostatic fluid from men with large volume prostate cancer, and also found some cytokines to be elevated in prostatic fluid associated with benign prostatic hyperplasia (BPH). We performed studies on both prostatic fluids obtained ex vivo, and on urine samples obtained after DRE in the clinic. We pursued several of the proteins that appeared most interesting to us re: prostate cancer and BPH in such samples, including endoglin, IL-18 binding protein-a (IL18BPa), and monocyte chemotactic protein-1 (MCP-1) and published manuscripts relating to these markers and their relationship to prostate pathology.
The original document contains color images.