Background/objectives: Prostate cancer (PCa) is the most common cancer among males. Approximately 20–40% of patients with clinically localized PCa will present with a biochemical recurrence after a radical prostatectomy (RP), while some will present with recurrent metastasis. Monitoring the disease post-treatment is crucial for detecting a potential cancer recurrence early. Urinary volatile organic compounds (VOCs) have shown potential to detect PCa. However, their application in disease monitoring remains unexplored. Methods: A total of 165 urine samples were collected from male adults with biopsy-designated PCa-positive results before (n= 55) and after a RP (n= 55), and with biopsy-designated PCa-negative diagnosis (n= 55). The post-RP cohort was subdivided into three groups based on their health status after surgery as recovered healthy, biochemical recurrence, and recurrent metastasis. VOCs in the urine samples were extracted by stir bar sorptive extraction and analyzed using gas chromatography and mass spectrometry. We explored the use of metabolomics and a machine learning algorithm tool to investigate the potential of using VOCs for differentiating PCa diagnoses before and after the RP procedure with different outcomes. Results: Over 100 potential VOCs were identified to differentiate PCa patients before and after a RP, and those with biochemical recurrence and recurrent metastasis. Conclusions: Urinary VOCs are promising biomarkers that could be used to differentiate PCa patients pre- and post-RP. The findings from this research provide preliminary insights and could aid future investigations in developing tools for PCa patients after treatment. The absence of a validation cohort limits the reproducibility and translational impact of these findings; therefore, the results should be considered exploratory and require confirmation in larger, independent cohorts.
背景/目的：前列腺癌是男性最常见的恶性肿瘤。约20%-40%临床局限性前列腺癌患者在根治性前列腺切除术后会出现生化复发，部分患者甚至会发生转移性复发。术后疾病监测对早期发现潜在癌症复发至关重要。尿液挥发性有机化合物在检测前列腺癌方面已显示出潜力，但其在疾病监测中的应用尚未得到探索。方法：本研究共收集165份男性尿液样本，包括前列腺穿刺活检阳性患者术前样本55份、术后样本55份，以及活检阴性对照样本55份。术后队列根据健康状况进一步分为康复组、生化复发组和转移复发组。采用搅拌棒吸附萃取技术提取尿液VOCs，并通过气相色谱-质谱联用仪进行分析。我们运用代谢组学与机器学习算法，探究VOCs在区分前列腺癌患者术前术后状态及不同预后结局中的潜力。结果：研究鉴定出100余种潜在VOCs标志物，可有效区分前列腺癌患者术前术后状态，并能鉴别生化复发与转移复发。结论：尿液VOCs作为生物标志物在区分前列腺癌患者术前术后状态方面具有应用前景。本研究为开发前列腺癌术后监测工具提供了初步依据，但缺乏验证队列限制了结果的可重复性与临床转化价值，因此当前发现应视为探索性成果，需在更大规模的独立队列中予以验证。
Urinary Metabolome Study for Monitoring Prostate Cancer Recurrence Following Radical Prostatectomy
肿瘤(癌症)患者之家