前立腺がんを検出する新しい尿検査法を開発(New Urine-Based Test to ID Prostate Cancers)

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2025-09-12 ジョンズ・ホプキンス大学

ジョンズ・ホプキンス大学の研究チームは、尿中のバイオマーカーを用いて前立腺がんを検出する新しい検査法を開発した。前立腺摘出前後の患者と健常者の尿を比較分析した結果、TTC3、H4C5、EPCAMの3種類のバイオマーカーが、がんの有無を強力に示すことが判明。これらは手術前には存在するが、摘出後にはほぼ消失するため、前立腺由来であることが裏付けられた。従来のPSA血液検査は特異度が低く、多くの患者に不要な侵襲的生検を受けさせる課題があったが、この尿検査は生検の必要性を大幅に減らせる可能性がある。研究成果は eBioMedicine に掲載され、単独利用だけでなくPSA検査と組み合わせた「スーパーPSA」としての応用も検討されている。

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前立腺癌検出のための高感度・高特異性非侵襲的尿バイオマーカーパネル A sensitive and specific non-invasive urine biomarker panel for prostate cancer detection

Menglang Yuan ∙ Marcio Covas Moschovas ∙ Kandarp Joshi ∙ Yohei Sanada ∙ Roshane A. Pererac∙ Bongyong Lee ∙ et al.
eBioMedicine  Published: September 2, 2025
DOI:https://doi.org/10.1016/j.ebiom.2025.105895

前立腺がんを検出する新しい尿検査法を開発(New Urine-Based Test to ID Prostate Cancers)

Summary

Background

Prostate cancer (PCa) is one of the leading causes of cancer death in men. While prostate-specific antigen (PSA) testing is widely used for screening, its diagnostic accuracy is limited, often failing to distinguish between benign and malignant prostate conditions, underscoring the need for novel biomarkers with improved diagnostic performance. This study aimed to identify and validate a panel of urinary RNA biomarkers with improved diagnostic accuracy for PCa.

Methods

RNA-sequencing analysis of exfoliated cells in urine specimens identified 50 candidate RNAs. After initial qPCR testing in pooled urine, three biomarkers (TTC3, H4C5, EPCAM) with optimal specificity and sensitivity were selected as a biomarker panel. Diagnostic performance was evaluated in a case–control study divided into development (n = 243 participants) and validation (n = 646 participants) datasets. Biomarker expression was confirmed in tissue specimens, and the oncogenic function of TTC3 was assessed in vitro and in vivo.

Findings

The three-biomarker urine panel robustly identified PCa with an area under the curve (AUC) of 0.96 (95% CI: 0.94–0.98) compared to 0.83 (95% CI: 0.77–0.88) for urinary prostate cancer antigen 3 (PCA3) RNA in the development dataset and 0.92 (95% CI: 0.89–0.94) compared to 0.76 (95% CI: 0.72–0.80) for PCA3 in the validation dataset. Urine biomarkers were nearly eliminated post-prostatectomy and were confirmed to originate from prostate tissue at both the RNA and protein levels. The panel maintained high diagnostic accuracy of PSA-negative PCa cases and distinguished PCa from benign prostate conditions (BPH, prostatitis). Functional studies demonstrated that TTC3 depletion significantly suppressed in vitro and in vivo tumour growth.

Interpretation

This urine-based biomarker panel offers a promising sensitive and specific noninvasive diagnostic for PCa with the potential to form the basis for laboratory-developed and in vitro diagnostic assays.

Funding

This study was supported by the International Prostate Cancer Foundation, JHU SKCCC (grant number P30CA006973), and Bankhead-Coley Cancer Research Program (grant number 24B16) to R. J. Perera and by the Maryland Innovation Initiative Grant to C. P. Pavlovich and R. J. Perera.

医療・健康
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