Blood-Based Biomarkers of Aggressive Prostate Cancer

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Author
Liong, Men Long
Lim, Chun Ren
Yang, Hengxuan
Chao, Samuel
Bong, Chin Wei
Leong, Wing Seng
Das, Prashanta Kumar
Loh, Chit Sin
Lau, Ban Eng
Yu, Choon Geok
Ooi, Edie Jian Jiek
Nam, Robert K.
Wassmann, Karl
Liew, Choong Chin
Note: Order does not necessarily reflect citation order of authors.
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https://doi.org/10.1371/journal.pone.0045802Metadata
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Liong, Men Long, Chun Ren Lim, Hengxuan Yang, Samuel Chao, Chin Wei Bong, Wing Seng Leong, Prashanta Kumar Das, et al. 2012. Blood-based biomarkers of aggressive prostate cancer. PLoS ONE 7(9): e45802.Abstract
Purpose: Prostate cancer is a bimodal disease with aggressive and indolent forms. Current prostate-specific-antigen testing and digital rectal examination screening provide ambiguous results leading to both under-and over-treatment. Accurate, consistent diagnosis is crucial to risk-stratify patients and facilitate clinical decision making as to treatment versus active surveillance. Diagnosis is currently achieved by needle biopsy, a painful procedure. Thus, there is a clinical need for a minimally-invasive test to determine prostate cancer aggressiveness. A blood sample to predict Gleason score, which is known to reflect aggressiveness of the cancer, could serve as such a test. Materials and Methods: Blood mRNA was isolated from North American and Malaysian prostate cancer patients/controls. Microarray analysis was conducted utilizing the Affymetrix U133 plus 2·0 platform. Expression profiles from 255 patients/controls generated 85 candidate biomarkers. Following quantitative real-time PCR (qRT-PCR) analysis, ten disease-associated biomarkers remained for paired statistical analysis and normalization. Results: Microarray analysis was conducted to identify 85 genes differentially expressed between aggressive prostate cancer (Gleason score ≥8) and controls. Expression of these genes was qRT-PCR verified. Statistical analysis yielded a final seven-gene panel evaluated as six gene-ratio duplexes. This molecular signature predicted as aggressive (ie, Gleason score ≥8) 55% of G6 samples, 49% of G7(3+4), 79% of G7(4+3) and 83% of G8-10, while rejecting 98% of controls. Conclusion: In this study, we have developed a novel, blood-based biomarker panel which can be used as the basis of a simple blood test to identify men with aggressive prostate cancer and thereby reduce the overdiagnosis and overtreatment that currently results from diagnosis using PSA alone. We discuss possible clinical uses of the panel to identify men more likely to benefit from biopsy and immediate therapy versus those more suited to an “active surveillance” strategy.Other Sources
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3461021/pdf/Terms of Use
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http://nrs.harvard.edu/urn-3:HUL.InstRepos:10522881
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