Circulating extracellular vesicle miRNAs for distinguishing prostate cancer from benign prostatic hyperplasia

Aim: Our previous studies identified three extracellular vesicle derived microRNAs (miR-92a-1-5p, miR-375 and miR-148a-3p) potentially associated with prostate cancer (PCa), particularly in advanced stages such as bone-metastatic PCa. This study aimed to evaluate their clinical diagnostic utility as a panel derived from plasma extracellular vesicles. Methods: A total of 49 treatment-naive participants, including 21 with benign prostatic hyperplasia (BPH), 15 with localized PCa, and 13 with bone-metastatic PCa, were enrolled. Plasma extracellular vesicles were isolated, and absolute quantification of the three miRNAs was performed using digital polymerase chain reaction (PCR). Their individual and combined diagnostic performance for distinguishing PCa from BPH and identifying bone metastasis was assessed. Results: Among the three miRNAs, miR-92a-1-5p and miR-375 showed a statistically significant difference in expression between PCa and BPH. The combined three-miRNA panel achieved an improved area under the curve (AUC) of 0.736, representing an enhancement over single markers and outperforming serum prostate-specific antigen (PSA) (AUC = 0.682) in this cohort. The panel yielded an AUC of 0.766 for detecting bone-metastatic PCa versus BPH, but showed limited ability to discriminate localized from metastatic disease. Conclusion: These preliminary findings suggest that the plasma extracellular vesicle-derived three-miRNA panel has auxiliary diagnostic value for differentiating prostate cancer from benign prostatic hyperplasia, and may serve as a supplementary tool to serum PSA.