Hoque MO et al. (2005) Quantitative methylation-specific polymerase chain reaction gene patterns in urine sediment distinguish prostate cancer patients from control subjects. J Clin Oncol 23: 6560–6575

Treatment of prostate cancer can be curative but depends on early detection. Although prostate-specific antigen (PSA) is widely regarded as one of the best serum tumor markers, PSA level alone is neither sensitive nor specific enough for a definitive diagnosis, and transrectal biopsies are needed to confirm prostate cancer. A recent study has demonstrated that the detection of aberrant promoter methylation using quantitative methylation-specific polymerase chain reaction (QMSP) in urine sediment DNA offers potential as a specific, sensitive and noninvasive test for prostate cancer.

Hoque and colleagues used QMSP to detect aberrant methylation of 9 gene promoters in urine sediment DNA from 52 prostate cancer patients and 91 normal, age-matched controls. Promoter hypermethylation of at least one gene was seen in all prostate cancer samples. No methylation of p16, ARF, MGMT or GSTP1 was seen in matched controls, although low levels were detected for the other promoters tested. Based on these data, the authors conclude that testing for aberrant methylation of p16, ARF, MGMT and GSTP1 using QMSP would theoretically allow for the detection of 87% of all prostate cancers with 100% specificity.

Detection of aberrant methylation in urine DNA offers a simple, readily automated, noninvasive means of detecting and monitoring prostate cancer. Using carefully selected methylation markers, the technique might also be useful for the detection of other urologic tumors that contribute cellular DNA to urine sediment.