PCA3 (Prostate cancer associated 3)

Additionally, the review addresses key genetic alterations implicated in prostate carcinogenesis, including mutations in BRCA1/2, HOXB13, and PTEN deletions, as well as changes in the androgen receptor pathway. By evaluating recent advancements and applications of these biomarkers, this review aims to enhance understanding of their role in improving early diagnosis, prognosis, and personalised management of prostate cancer.

Furthermore, serum Phi combined with urinary PCA3-T2:ERG outperformed urinary PCA3-T2:ERG in each of the 3 algorithms reflecting different potential clinical workflows: (1) serum Phi and urine PCA3-T2:ERG tested simultaneously, either exceeding its own threshold (P = .04); (2) urine PCA3-T2:ERG first and those in the grey zone resolved by subsequent serum Phi (P = .03); and (3) serum Phi first and those in the grey zone resolved by subsequent urine PCA3-T2:ERG (P = .002). Combining serum Phi with urinary PCA3 RNA alone or together with urinary T2:ERG RNA, simultaneously or sequentially, improves selection of men for initial prostate biopsy and represents an avenue to improve early detection of aggressive PCa.

To validate these findings, we constructed a PCA3 promoter-driven transcriptional reporter system, which exhibited elevated activity in lower-grade PCa, reinforcing the differential expression pattern of PCA3 across pathological grades. Our findings suggest that PCA3 could serve as a robust and clinically valuable biomarker for predicting PCa pathological grade.

Clinically implemented assays, including PCA3, ConfirmMDx, and ExoDx Prostate, along with emerging multi-analyte panels, enhance risk stratification, reduce unnecessary biopsies, and guide therapeutic decisions. Integration of epigenetic and liquid biopsy biomarkers into multimodal diagnostic pathways has the potential to support personalized management of prostate cancer; however, many still require further validation and optimization.

Despite slightly decreased performance, the TR-FRET nanoassay demonstrated reliable quantification of nanomolar PCA3 concentrations also in samples containing up to 50% of serum. These findings underscore the potential of Tb-to-QD FRET assays for rapid clinical prostate cancer diagnostics, offering a promising tool for the early detection of PCA3 in a noninvasive manner.

AI-assisted SELEX is a promising strategy for accelerating high-affinity aptamer discovery and assembling multiplex urinary panels for PCa, but current evidence is early phase, heterogeneous, and largely single-center. Priorities include standardized uEV processing, complete 2 × 2 diagnostic reporting, multicenter external validation, calibration and decision impact analyses, and harmonized LoD and Kd reporting frameworks.

Liquid biopsy demonstrates strong diagnostic and prognostic potential across GU cancers. While bladder and prostate cancer assays are most advanced, emerging evidence in UTUC and kidney cancer is encouraging. Prospective, longitudinal validation remains essential before widespread clinical adoption.

This narrative review demonstrates that although PSA remains the mainstay of prostate cancer diagnosis, emerging molecular and genomic biomarkers are enhancing diagnostic specificity, refining risk stratification, and enabling more personalized patient care. The integration of routinely used and novel biomarkers can improve early detection, optimize treatment decisions, and ultimately improve outcomes of prostate cancer patients.

Moreover, integrating multi‑omics data with artificial intelligence and machine learning may further improve early detection and personalized treatment strategies. Overall, the development and clinical implementation of these biomarkers represent a transformative step toward precision medicine in prostate cancer, enabling earlier diagnosis, optimized therapy selection and improved patient outcomes.

Key markers such as miR-141, miR-375, and PCA3 showed strong diagnostic and risk stratification value in PCa. This non-invasive approach holds promise for improving early detection and clinical risk assessment.

LINC01949 suppresses rituximab resistance in DLBCL by promoting H3K27me3-dependent silencing of ONECUT2. These findings highlight the LINC01949-H3K27me3-ONECUT2 axis as a key epigenetic pathway and suggest potential targets to overcome resistance in DLBCL.

This study is the first to explore nisin's anticancer effects in prostate cancer, uniquely targeting PCA3 lncRNA and its downstream regulatory pathways. Nisin demonstrates potent anticancer effects in prostate cancer cells by inducing apoptosis, arresting cell cycle progression, and modulating the PCA3 lncRNA network, suggesting its potential as a novel therapeutic agent.