Differentiation of high risk prostate cancer with a facile urinary exosome detection workflow
Clear differentiation of high-grade and clinically insignificant prostate cancer (PCa) is critical for clinical decision-making. Here, we developed a proprietary urinary exosome isolation approach (EVLatch) and established a facile diagnostic workflow. We discovered that <i>EEF1A1</i> levels, abundantly expressed on urinary exosomes, positively correlate to urinary exosome counts irrespective of source and collection time and demonstrated that <i>EEF1A1</i> enables in-assay quantification of urinary exosomes. Importantly, a prostate cancer urinary EVLatch-based artificial intelligence diagnostics (PURE-AID) classification system utilizing <i>PCA3</i>, <i>HOXC6</i>, and <i>DLX1</i> as targets with <i>SPDEF</i> for reference and <i>EEF1A1</i> for quality checking, trained on 271 patients, achieved an area under the receiver operating characteristic curve (AUROC) of 0.76 in the test set of 351 patients. Combination of PURE-AID with prostate-specific antigen (PSA) and age increases AUROC to 0.80 and reduces 54.3% of unnecessary biopsies with 86.8% sensitivity. Our study provides a new classification system for differentiating high-grade PCa in a workflow- and patient-friendly manner.
Authors
- HaiFang Yin (ORCID: https://orcid.org/0000-0001-8774-2864)
- Simeng Wen (ORCID: https://orcid.org/0000-0001-7989-7700)
- Shuai Qiu (ORCID: https://orcid.org/0000-0001-7594-7619)
- Zifei Li (ORCID: https://orcid.org/0000-0001-6097-3494)
- Ranlu Liu (ORCID: https://orcid.org/0000-0002-5806-2795)
- Ruibing Chen (ORCID: https://orcid.org/0000-0002-1149-8049)
- Chunchang Li
- Jinhong Guo (ORCID: https://orcid.org/0009-0006-6086-4224)
- Hua Huang (ORCID: https://orcid.org/0000-0002-8936-3371)
- Hongtuan Zhang (ORCID: https://orcid.org/0000-0002-0561-0014)
- Yiqi Seow (ORCID: https://orcid.org/0000-0001-7040-3006)
- Ao Chen (ORCID: https://orcid.org/0000-0002-9699-8340)
- Yi Liu (ORCID: https://orcid.org/0000-0003-0184-4363)
- Yan Liu (ORCID: https://orcid.org/0000-0003-4242-4840)
- Yue Li (ORCID: https://orcid.org/0000-0002-1898-9027)
- Zheng Zhang (ORCID: https://orcid.org/0000-0002-7664-2793)
- Yong Wang (ORCID: https://orcid.org/0000-0002-1594-6240)
- Jing Tian (ORCID: https://orcid.org/0000-0002-3892-9056)
- Gang Han (ORCID: https://orcid.org/0000-0001-8533-8323)
- Baolong Wang (ORCID: https://orcid.org/0000-0003-0163-7575)
- Yan Zhi (ORCID: https://orcid.org/0000-0003-3945-3915)
- Yuanjie Niu
- Haoyu Wang (ORCID: https://orcid.org/0000-0003-1100-8633)
Institutions
- Agency for Science, Technology and Research (SG)
- Shanghai Jiao Tong University (CN)
- Tianjin Medical University General Hospital (CN)
- Second Hospital of Tianjin Medical University (CN)
- Tianjin Medical University (CN)
Publication Details
- Journal
- iScience
- Published
- 2025-01-27
- DOI
- https://doi.org/10.1016/j.isci.2025.111896
- Citations
- 1
- Primary Topic
- Prostate Cancer Diagnosis and Treatment
- Type
- article
- Field-Weighted Citation Impact
- 1.52
Funders
- National Natural Science Foundation of China
- Tianjin Medical University