Urinary thiosulfate as failed prostate cancer biomarker – an exemplary multicenter re-evaluation study

Carsten Stephan; Jacek Wilkosz; Waldemar Różański; Thorsten H. Ecke; Michael Lein; Magdalena Bryś; Anna Krześlak; Grażyna Chwatko; Klaus Jung

doi:10.1515/cclm-2014-0729

Article

Urinary thiosulfate as failed prostate cancer biomarker – an exemplary multicenter re-evaluation study

Carsten Stephan , Jacek Wilkosz , Waldemar Różański , Thorsten H. Ecke , Michael Lein , Magdalena Bryś , Anna Krześlak , Grażyna Chwatko and Klaus Jung

Published/Copyright: September 30, 2014

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From the journal Clinical Chemistry and Laboratory Medicine (CCLM) Volume 53 Issue 3

Abstract

Background: In 2013, thiosulfate in urine has been proposed as promising prostate cancer (PCa) biomarker. However, a missing comparison with other proven PCa markers suggested a re-evaluation study. Therefore, together with the authors from the initial study, the diagnostic accuracy of thiosulfate was compared with that of urinary prostate cancer associated 3 (PCA3), serum prostate health index (Phi), and percent free prostate-specific antigen (%fPSA). Thiosulfate was further measured in a multicenter approach to exclude center-related biases.

Methods: Thiosulfate, calculated as ratio of thiosulfate to urinary creatinine (TS/Crea ratio), was measured in two cohorts in a total of 269 patients. In the retrospective study (n=160) PCA3, Phi, PSA, and %fPSA were compared with the TS/Crea ratio between patients with and without PCa according to the prostate needle biopsy results. The second prospective cohort included 109 patients from four centers.

Results: The median TS/Crea ratio was not statistically different between the patients with and without PCa. The receiver-operating characteristics showed that the TS/Crea ratio was unable to discriminate between patients with and without PCa in contrast to %fPSA, Phi, and PCA3. In all four centers, the low median TS/Crea ratios (<1 mmol/mol) in both patient cohorts were confirmed and thiosulfate was again not able to distinguish between them (p-values, 0.13–0.90).

Conclusions: This study could not confirm the previously observed high median TS/Crea ratio in PCa patients in comparison to non-PCa patients. Thiosulfate subsequently failed as PCa biomarker while PCA3 and Phi showed the expected diagnostic improvement.

Keywords: biomarker; PCA3; Phi; prostate cancer; prostate- specific antigen; thiosulfate

Corresponding author: Klaus Jung, Department of Urology, University Hospital Charité and Berlin Institute for Urologic Research, Schumannstrasse 20/21, 10117 Berlin, Germany, Phone: +49 30 450 515041, E-mail: klaus.jung@charite.de

aCarsten Stephan, Jacek Wilkosz, Waldemar Różański, Grażyna Chwatko and Klaus Jung shared first and senior authorship, respectively.

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Received: 2014-7-15

Accepted: 2014-9-2

Published Online: 2014-9-30

Published in Print: 2015-2-1

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Articles in the same Issue

https://doi.org/10.1515/cclm-2014-0729

Keywords for this article

biomarker; PCA3; Phi; prostate cancer; prostate- specific antigen; thiosulfate