Urinary exosome microRNA signatures as a noninvasive prognostic biomarker for prostate cancer

Predicting the risk of metastasis before starting prostate cancer (PCa) treatment can minimize the overtreatment of indolent cases and help choosing appropriate treatment. The levels of circulating microRNAs (miRNAs) from body fluids can be used as noninvasive prognostic biomarkers. In this study, urinary exosomal miRNA expression profiles of 149 PCas were determined and the miRNAs associated with metastasis were identified: miR-21, miR-16, miR-142-3p, miR-451, and miR-636. When evaluating clinical factors together, miR-21, miR-451, miR-636, and preoperative prostate-specific antigen (PSA) level remained significant in the multivariate analysis. Based on them, we developed a Prostate Cancer Metastasis Risk Scoring (PCa-MRS) model. The PCa-MRS showed superior stratification power (AUC = 0.925) to preoperative PSA or clinical Gleason score. Patients with high scores showed significantly poorer biochemical recurrence-free survival than those with low scores (P = 6.53 x 10(-10)). Our results showed the potential of urinary exosomal miRNAs as noninvasive markers for predicting metastasis and prognosis in PCa patients.

Automated summary

This study identified urinary exosomal miRNAs miR-21, miR-451, and miR-636 as potential markers for predicting metastasis in prostate cancer. A PCa-MRS model was developed based on these miRNAs, showing superior stratification power and significant association with biochemical recurrence-free survival.