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JNCI Journal of the National Cancer Institute 2003 95(21):1634-1637; doi:10.1093/jnci/djg082
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© 2003 Oxford University Press

BRIEF COMMUNICATION

Quantitative GSTP1 Methylation and the Detection of Prostate Adenocarcinoma in Sextant Biopsies

Susan V. Harden, Harriette Sanderson, Steven N. Goodman, Alan A. W. Partin, Patrick C. Walsh, Jonathan I. Epstein, David Sidransky

Affiliation of authors: Department of Otolaryngology-Head and Neck Surgery (SVH, DS), Department of Pathology (HES, JIE), Department of Urology (AAWP, PCW), Department of Biostatistics/Oncology (SNG), The Johns Hopkins University School of Medicine, Baltimore, MD.

Correspondence to: David Sidransky, MD, Department of Otolaryngology-Head and Neck Surgery, The Johns Hopkins University School of Medicine, 818 Ross Research Bldg., 720 Rutland Ave., Baltimore, MD 21205-2196 (e-mail: dsidrans{at}jhmi.edu).

ABSTRACT

Hypermethylation of the 5' promoter region of the glutathione S-transferase {pi} gene (GSTP1) occurs at a very high frequency in prostate adenocarcinoma. We compared the results of blinded histologic review of sextant biopsy samples from 72 excised prostates with those obtained using a quantitative methylation-specific polymerase chain reaction assay (QMSP) for GSTP1. Formal surgical pathologic review of the resected prostates was used to determine the number of patients with (n = 61) and without (n = 11) prostate cancer. Histology alone detected prostate carcinoma with 64% sensitivity (95% confidence interval [CI] = 51% to 76%) and 100% specificity (95% CI = 72% to 100%), whereas the combination of histology and GSTP1 QMSP at an assay threshold greater than 10 detected prostate carcinoma with 75% sensitivity (95% CI = 63% to 86%) and 100% specificity (95% CI = 72% to 100%), an 11% improvement (95% CI = 5% to 22%) in sensitivity over histology alone. The combination of histology and GSTP1 QMSP at an assay threshold greater than 5 detected prostate adenocarcinoma with 79% sensitivity (95% CI = 68% to 89%), a 15% improvement (95% CI = 7% to 26%) over histology alone. Thus, GSTP1 QMSP improved the sensitivity of histologic review of random needle biopsies for prostate cancer diagnosis. Further studies should determine whether detection of GSTP1 hypermethylation in a biopsy sample with normal histology indicates the need for an early repeat biopsy at the same site.


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