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Another possible urine test for detection of prostate cancer?

Posted Mar 02 2011 12:00am

A study just published in Clinical Cancer Research suggests that levels of a protein called engrailed-2 (EN2) in urine may be indicative of risk for prostate cancer.

According to the new article by Morgan et al. , they carried out initial tests by measuring the levels of EN2 in the “first-pass” urine (prior to any digital rectal examination) of men with urinary symptoms referred to their clinic to exclude or confirm for the presence of prostate cancer and in a series of normal “controls.”

The results from this initial trial are as follows:

  • Tests were conducted on urine for 82 men known to have prostate cancer and on 102 controls.
  • The presence of EN2 was predictive of prostate cancer with a sensitivity of 66 percent and a specificity of 88.2 percent.
  • There was no correlation between the presence of EN2 and the level of PSA.

The authors were able to confirm these initial results in tests independently conducted at a second academic center. They conclude only that urinary EN2 is a potential candidate biomarker of prostate cancer, and that a larger multi-center study will be necessary in order to better assess the diagnostic potential of EN2.

According to information from the Press Association in the UK, EN2 is a protein that is normally expressed during the development of human embryos, but is switched off at the time of a child’s birth. The researchers have been able to show that expression of EN2 is re-activated in a large percentage of men with prostate cancer.

Professor Hardev Pandha of the University of Surrey, the leader of the research team, is quoted as saying: “In this study we showed that the new test was twice as good at finding prostate cancer as the standard PSA test. Only rarely did we find EN2 in the urine of men who were cancer free so, if we find EN2 we can be reasonably sure that a man has prostate cancer.”

There would be great value in a simple urine test that is highly predictive of risk for prostate cancer especially if data from such a test could be combined with PSA data to give a better ability to differentiate between risk levels for prostate cancer. However, The “New” Prostate Cancer InfoLink recognizes that potential tests like this have been identified before and gone nowhere, so we will need to wait and see whether further data confirm the initial promise of EN2.


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