Poster Presentation – Abstracts Archive

UK & Ireland Prostate Brachytherapy Conference 2013

Abstract number 10

An Update on Urinary Engrailed-2 (EN2), a Novel Biomarker for Detection of Prostate Cancer and its Correlation with Tumour Volume and Pathological Stage

Saqib Javed
Royal Surrey County Hospital, Guildford
Albert Edwards
Royal Surrey County Hospital, Guildford
Hardev Pandha
Faculty of Health and Medical Sciences, University of Surrey, Guildford
Richard Morgan
Faculty of Health and Medical Sciences, University of Surrey, Guildford
Robert Laing
Royal Surrey County Hospital, Guildford
Stephen Langley
Royal Surrey County Hospital, Guildford

Aims/Introduction: Last year we showed our preliminary results on a pilot study which suggested that EN-2 may be a useful surveillance marker in patients who have undergone low dose rate brachytherapy for prostate cancer. Adding further to this we assessed the relationship between pre-prostatectomy urinary Engrailed-2 (EN2) with tumour volume and pathological characteristics in radical prostatectomy specimens.

Materials/Methods: Patients first pass urine samples (10 ml) without prior digital rectal examination were collected and stored at 80°C. EN2 levels were measured using an enzyme-linked immunoabsorbent assay. Tumour volume in the prostatectomy specimens was determined histologically by a dedicated uropathologist.

Results: 57 men undergoing RP in one urological cancer network were evaluated. EN2 was detected in 85% of RP patients. EN2 correlated with tumour volume (but not total prostatic volume) in a linear regression analysis, with increasing pathological T stage and margin positivity. Using three cut-off levels of tumour volume (0.5 ml, 1.3 ml and 2.5 ml) to define ‘significant disease’, men with ‘significant disease’ had markedly higher levels of urinary EN2 (p < 0.001 for each cut off level).

Conclusions: Urinary EN2 levels closely reflected tumour volume in prostatectomy specimens. Levels of urinary EN2 may be useful in predicting tumour volume in men with prostate cancer by potentially identifying men with small volume ‘insignificant’ disease. This may help in critical decision making in the management of PC patients i-e active surveillance vs radical treatment. This study justifies a larger multicentre evaluation of urinary EN2 levels as a biomarker of PC significance using cancer volume, pathological and PSA criteria.