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Objective <p>Prostate-specific antigen (PSA) has served as a screening tool for prostate cancer (PCa) for over 30 years, but its low specificity remains a significant limitation. Liquid biopsy based on promoter methylation, an epigenetic modification, holds significant potential to complement PSA testing and enhance the diagnostic accuracy of PCa. Our objective was to assess the diagnostic accuracy of liquid biopsy for promoter methylation in PCa.</p> Methods <p>We conducted a comprehensive search to screen clinical studies on the application of liquid biopsy for promoter methylation in PCa diagnosis. Subgroup analyses were performed based on sample type, area, control type, method, timing of prostatectomy or prostate massage, and promoter type. The quality of the included articles was evaluated using the Quality Assessment of Diagnostic Accuracy Studies-2 tool.</p> Results <p>We included 31 studies with a total of 3,880 participants. The results indicated that the sensitivity of promoter methylation detected via liquid biopsy for PCa was 0.55 (95% confidence interval [CI], 0.42–0.67) and the specificity was 0.87 (95% CI, 0.83–0.89), with an area under the curve (AUC) of 0.87 (95% CI, 0.83–0.89). In the serum sample group, specificity reached 0.97 (95% CI, 0.92–0.98), and both the positive likelihood ratio and AUC demonstrated excellent diagnostic performance.</p> Conclusions <p>Liquid biopsy for promoter methylation shows excellent specificity for PCa diagnosis, particularly in serum samples. However, further large-scale studies are required before its superiority over PSA testing can be fully established.</p>

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Liquid biopsy for promoter methylation in prostate cancer: a promising non-invasive diagnostic weapon

  • 期刊论文

  • 发表日期：

    2025年6月3日

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  • Zeyu Han,
  • Yize Zhao,
  • Yaxiong Tang,
  • Xianyanling Yi,
  • Jin Li,
  • Xuanji Li,
  • Dazhou Liao,
  • Ye Zhu,
  • Jianzhong Ai

摘要

Objective

Prostate-specific antigen (PSA) has served as a screening tool for prostate cancer (PCa) for over 30 years, but its low specificity remains a significant limitation. Liquid biopsy based on promoter methylation, an epigenetic modification, holds significant potential to complement PSA testing and enhance the diagnostic accuracy of PCa. Our objective was to assess the diagnostic accuracy of liquid biopsy for promoter methylation in PCa.

Methods

We conducted a comprehensive search to screen clinical studies on the application of liquid biopsy for promoter methylation in PCa diagnosis. Subgroup analyses were performed based on sample type, area, control type, method, timing of prostatectomy or prostate massage, and promoter type. The quality of the included articles was evaluated using the Quality Assessment of Diagnostic Accuracy Studies-2 tool.

Results

We included 31 studies with a total of 3,880 participants. The results indicated that the sensitivity of promoter methylation detected via liquid biopsy for PCa was 0.55 (95% confidence interval [CI], 0.42–0.67) and the specificity was 0.87 (95% CI, 0.83–0.89), with an area under the curve (AUC) of 0.87 (95% CI, 0.83–0.89). In the serum sample group, specificity reached 0.97 (95% CI, 0.92–0.98), and both the positive likelihood ratio and AUC demonstrated excellent diagnostic performance.

Conclusions

Liquid biopsy for promoter methylation shows excellent specificity for PCa diagnosis, particularly in serum samples. However, further large-scale studies are required before its superiority over PSA testing can be fully established.