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Article

The Urine Biomarker PUR-4 Is Positively Associated with the Amount of Gleason 4 in Human Prostate Cancers

1
Norfolk and Norwich University Hospitals NHS Foundation Trust, Norwich NR4 7UY, UK
2
Norwich Medical School, University of East Anglia, Norwich NR4 7TJ, UK
3
Urology Department Castle Hill, Hull University Teaching Hospital, Castle Rd, Cottingham HU16 5JQ, UK
4
Institute of Cancer Research, Sutton SM2 5NG, UK
5
Royal Marsden Hospital, Sutton SM2 5PT, UK
6
Earlham Institute, Norwich NR4 7UZ, UK
*
Author to whom correspondence should be addressed.
Academic Editors: Ana Faustino and Paula A. Oliveira
Life 2021, 11(11), 1172; https://doi.org/10.3390/life11111172
Received: 30 September 2021 / Revised: 18 October 2021 / Accepted: 20 October 2021 / Published: 3 November 2021
(This article belongs to the Special Issue Prostate Cancer)
The Prostate Urine Risk (PUR) biomarker is a four-group classifier for predicting outcome in patients prior to biopsy and for men on active surveillance. The four categories correspond to the probabilities of the presence of normal tissue (PUR-1), D’Amico low-risk (PUR-2), intermediate-risk (PUR-3), and high-risk (PUR-4) prostate cancer. In the current study we investigate how the PUR-4 status is linked to Gleason grade, prostate volume, and tumor volume as assessed from biopsy (n = 215) and prostatectomy (n = 9) samples. For biopsy data PUR-4 status alone was linked to Gleason Grade group (GG) (Spearman’s, ρ = 0.58, p < 0.001 trend). To assess the impact of tumor volume each GG was dichotomized into Small and Large volume cancers relative to median volume. For GG1 (Gleason Pattern 3 + 3) cancers volume had no impact on PUR-4 status. In contrast for GG2 (3 + 4) and GG3 (4 + 3) cancers PUR-4 levels increased in large volume cancers with statistical significance observed for GG2 (p = 0.005; Games-Howell). These data indicated that PUR-4 status is linked to the presence of Gleason Pattern 4. To test this observation tumor burden and Gleason Pattern were assessed in nine surgically removed and sectioned prostates allowing reconstruction of 3D maps. PUR-4 was not correlated with Gleason Pattern 3 amount, total tumor volume or prostate size. A strong correlation was observed between amount of Gleason Pattern 4 tumor and PUR-4 signature (r = 0.71, p = 0.034, Pearson’s). These observations shed light on the biological significance of the PUR biomarker and support its use as a non-invasive means of assessing the presence of clinically significant prostate cancer. View Full-Text
Keywords: prostate; cancer; urine; PUR; PUR-4; Gleason pattern 4 prostate; cancer; urine; PUR; PUR-4; Gleason pattern 4
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MDPI and ACS Style

Ball, R.Y.; Cardenas, R.; Winterbone, M.S.; Hanna, M.Y.; Parker, C.; Hurst, R.; Brewer, D.S.; D’Sa, L.; Mills, R.; Cooper, C.S.; Clark, J. The Urine Biomarker PUR-4 Is Positively Associated with the Amount of Gleason 4 in Human Prostate Cancers. Life 2021, 11, 1172. https://doi.org/10.3390/life11111172

AMA Style

Ball RY, Cardenas R, Winterbone MS, Hanna MY, Parker C, Hurst R, Brewer DS, D’Sa L, Mills R, Cooper CS, Clark J. The Urine Biomarker PUR-4 Is Positively Associated with the Amount of Gleason 4 in Human Prostate Cancers. Life. 2021; 11(11):1172. https://doi.org/10.3390/life11111172

Chicago/Turabian Style

Ball, Richard Y., Ryan Cardenas, Mark S. Winterbone, Marcelino Y. Hanna, Chris Parker, Rachel Hurst, Daniel S. Brewer, Lauren D’Sa, Rob Mills, Colin S. Cooper, and Jeremy Clark. 2021. "The Urine Biomarker PUR-4 Is Positively Associated with the Amount of Gleason 4 in Human Prostate Cancers" Life 11, no. 11: 1172. https://doi.org/10.3390/life11111172

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