BERKELEY, CA (UroToday.com) - At The Royal Surrey County Hospital and University of Surrey, we are evaluating the role of Engrailed-2 (EN2) in the diagnosis and monitoring of prostate cancer. EN2 belongs to the family of HOX genes, which have been studied in the fruit fly and mammals. They are expressed in embryonic brain development and subsequently re-expressed by several different types of cancers.
Earlier diagnosis and management of prostate cancer may result in better patient outcomes. Current diagnostic tests such as serum PSA may give falsely high values in various benign conditions of the prostate gland. Hence there is a need for a new biomarker which has high sensitivity and specificity and can be used reliably in screening for prostate cancer. Such a biomarker should ideally facilitate risk stratification to distinguish clinically significant prostate cancer requiring active treatment from clinically insignificant disease, which may be managed with active surveillance. A new biomarker should also be able to adequately monitor the response to treatment, as it important in the follow up of these patients. Urinary EN2 has shown some promise in both of these areas.
Recent studies from our group have demonstrated that urinary EN2 may be clinically useful as a diagnostic test for prostate cancer. We have also shown that there are significant correlations between pre-prostatectomy urinary EN2 levels, pathological tumour stage, and tumour volume in radical prostatectomy specimens. This can help clinicians in determining the volume and stage of prostate cancer prior to treatment, and to plan various treatment options.
Urinary EN2 remains stable at room temperature for up to 4 days. It is a simple urine test that does not require prior digital rectal examination. This has enabled us to get subjects to collect their urine samples at home and post them to the laboratory. This makes it a very attractive and feasible test for patients and clinicians.
Urinary EN2 may be useful in different clinical situations. We are currently assessing the expression of urinary EN2 in various groups of men: healthy volunteers, patients on active surveillance, men who have completed radical treatment and are deemed ‘cured’ of prostate cancer, and men before and after hormone therapy and radical treatment for prostate cancer. The results of these pilot studies will be published as soon as they are available.
Written by:
Saqib Javed and Stephen E. M. Langley as part of Beyond the Abstract on UroToday.com. This initiative offers a method of publishing for the professional urology community. Authors are given an opportunity to expand on the circumstances, limitations etc... of their research by referencing the published abstract.
Royal Surrey County Hospital, Guildford, Surrey, GU2 7XX United Kingdom
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