Decreased fucosylated PSA as a urinary marker for high Gleason score prostate cancer
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Kazutoshi Fujita1, Takuji Hayashi1, Kyosuke Matsuzaki1, Wataru Nakata1, Mika Masuda2, Atsunari Kawashima1, Takeshi Ujike1, Akira Nagahara1, Mutsumi Tsuchiya1, Yuka Kobayashi3, Satoshi Nojima4, Motohide Uemura1, Eiichi Morii4, Eiji Miyoshi2, Norio Nonomura1
1Department of Urology, Osaka University Graduate School of Medicine, Suita, Japan
2Department of Molecular Biochemistry and Clinical Investigation, Osaka University Graduate School of Medicine, Suita, Japan
3J-Oil Mills, Inc., Yokohama, Japan
4Department of Pathology, Osaka University Graduate School of Medicine, Suita, Japan
Kazutoshi Fujita, email: firstname.lastname@example.org
Keywords: prostate cancer, fucosylation, PSA, urine, Gleason score
Received: May 30, 2016 Accepted: July 13, 2016 Published: August 01, 2016
Fucosylation is an important oligosaccharide modification associated with cancer and inflammation. We investigated whether urinary fucosylated PSA (Fuc-PSA) levels could be used for the detection of high Gleason score prostate cancer. Urine samples were collected from men with abnormal digital rectal examination findings or elevated serum PSA levels, before prostate biopsy. Lectin-antibody ELISA was used to quantify the Lewis-type or core-type fucosylated PSA (PSA-AAL) and core-type fucosylated PSA (PSA-PhoSL) in the urine samples. Both types of urinary Fuc-PSA were significantly decreased in the men with prostate cancer compared with the men whose biopsies were negative for cancer (P = 0.026 and P < 0.001, respectively). Both were also significantly associated with the Gleason scores of the biopsy specimens (P = 0.001 and P < 0.001, respectively). Multivariate analysis showed that PSA density, urinary PSA-AAL, and urinary PSA-PhoSL were independent predictors of high Gleason score prostate cancer. The area under the receiver-operator characteristic curve (AUC) value for the prediction of cancers of Gleason score ≥ 7 was 0.69 for urinary PSA-AAL and 0.72 for urinary PSA-PhoSL. In contrast, the AUC value was 0.59 for serum PSA, 0.63 for PSA density, and 0.58 for urinary PSA. In conclusion, a decreased urinary Fuc-PSA level is a potential marker for the detection of high Gleason score prostate cancer.
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