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Urinary microRNAs for prostate cancer diagnosis, prognosis, and treatment response: are we there yet?

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Prostate cancer (PCa) remains one of the leading causes of cancer‐related deaths in men. Despite the tremendous progress in research over the years, a suitable minimally invasive PCa biomarker is yet to be discovered. The recent advances regarding the roles of microRNAs as biomarkers has allowed for their study in PCa as well, especially as blood‐based markers. However, there are several studies that used urine as biological sample to evaluate microRNAs as biomarkers for PCa diagnosis, prognosis, and treatment response, which were reviewed herein. A high degree of inconsistency among reports has been observed, which could be due to several analytical aspects, starting with different urinary fractions used for analysis and continuing with the employment of various analytical platforms and methods of statistical analysis. However, a few microRNAs were found to be dysregulated in the urine of PCa patients, which alone or together with serum prostate‐specific antigen seem to improve diagnostic power even in the gray zone of PCa. These results warrant further confirmation by larger prospective studies, preferably using a standardized protocol for analysis. WIREs RNA 2017, 8:e1438. doi: 10.1002/wrna.1438 This article is categorized under: RNA in Disease and Development > RNA in Disease
Strategies used to identify PCa‐specific urinary miRNAs. (a) Screening and validation of PCa‐related urinary miRNAs from microvesicles (exosomes and prostasomes), cell‐free miRNAs (cfmiRNAs) or cell pellet. (b) Screening of PCa‐related miRNAs in cell lines or tissues followed by urine validation. The second approach could increase the prostate specificity of miRNAs identified from the entire urinary tract starting from the kidney to the bladder, in addition to prostate cells.
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PCa‐specific urinary miRNAs with role in diagnosis, prognosis, and treatment response. The miRNAs presented in red were found to be at high levels while those shown in green were found to be at low levels in the urine of prostate cancer patients compared with the control group (healthy and/or benign prostate patients). All selected miRNAs were described as useful tools for PCa diagnosis. MiR‐888 was proposed as biomarker in PCa prognosis while miR‐34a was proposed as useful tool in prognosis and treatment prediction. Mir‐574‐3p and miR‐148a was the only species identified both in exosomes and cell pellet of two different studies.
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