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Background  Additional accurate non-invasive biomarkers are needed in the clinical setting to improve prostate cancer (PCa) diagnosis. Here we have developed a new and improved multiplex mRNA urine test to detect prostate cancer (PCa). Furthermore, we have validated the  PCA3  urinary transcript and some panels of urinary transcripts previously reported as useful diagnostic biomarkers for PCa in our cohort.    Methods  Post-prostatic massage urine samples were prospectively collected from PCa patients and controls. Expression levels of 42 target genes selected from our previous studies and from the literature were studied in 224 post-prostatic massage urine sediments by quantitative PCR. Univariate logistic regression was used to identify individual PCa predictors. A variable selection method was used to develop a multiplex biomarker model. Discrimination was measured by ROC curve AUC for both, our model and the previously published biomarkers.    Results  Seven of the 42 genes evaluated ( PCA3, ELF3, HIST1H2BG, MYO6, GALNT3, PHF12  and  GDF15 ) were found to be independent predictors for discriminating patients with PCa from controls. We developed a four-gene expression signature ( HIST1H2BG, SPP1, ELF3  and  PCA3 ) with a sensitivity of 77 % and a specificity of 67 % (AUC = 0.763) for discriminating between tumor and control urines. The accuracy of  PCA3  and previously reported panels of biomarkers is roughly maintained in our cohort.    Conclusions  Our four-gene expression signature outperforms  PCA3  as well as previously reported panels of biomarkers to predict PCa risk. This study suggests that a urinary biomarker panel could improve PCa detection. However, the accuracy of the panels of urinary transcripts developed to date, including our signature, is not high enough to warrant using them routinely in a clinical setting.    Electronic supplementary material  The online version of this article (doi:10.1186/s12885-016-2127-2) contains supplementary material, which is available to authorized users.

bmc cancer

Using gene expression from urine sediment to diagnose prostate cancer: development of a new multiplex mRNA urine test and validation of current biomarkers