VPAC receptor positivity in comparison with mp-MRI in the diagnosis of prostate cancer: A preliminary study

Nishant Setya; Shridhar C Ghagane; Rajendra B Nerli; Ashwin Bokare; Madhukar L Thakur; Leonard Gomella

doi:10.1002/bco2.70006

VPAC receptor positivity in comparison with mp-MRI in the diagnosis of prostate cancer: A preliminary study

BJUI Compass. 2025 Apr 22;6(4):e70006. doi: 10.1002/bco2.70006. eCollection 2025 Apr.

Authors

Nishant Setya¹, Shridhar C Ghagane^{2

3}, Rajendra B Nerli^{1

3}, Ashwin Bokare¹, Madhukar L Thakur^{4

5

6}, Leonard Gomella^{5

6}

Affiliations

¹ Department of Urology, J.N. Medical College KLE Academy of Higher Education and Research (Deemed-to-be-University) Belagavi India.
² KAHER's Dr. Prabhakar Kore Basic Science Research Center KLE Academy of Higher Education and Research (Deemed-to-be-University) Belagavi India.
³ Division of Urologic-oncology, Urinary Biomarkers Research Centre KLES Dr. Prabhakar Kore Hospital and Medical Research Centre Belagavi India.
⁴ Departments of Urology, Radiology Thomas Jefferson University Philadelphia Pennsylvania USA.
⁵ Departments of Urology Thomas Jefferson University Philadelphia Pennsylvania USA.
⁶ Sidney Kimmel Cancer Centre Thomas Jefferson University Philadelphia Pennsylvania USA.

Abstract

Objective: The study aimed to prospectively evaluate the feasibility of diagnosing PCa using voided urine samples and by targeting the genomic VPAC (vasoactive intestinal peptide and pituitary adenylate cyclase-activating peptide) receptors in comparison with multiparametric magnetic resonance imaging (mp-MRI) in male patients (≥40 years of age) with lower urinary tract symptoms and having a serum PSA of >4 but <15 ng/ml.

Patients and methods: Male patients attending urological services ≥40 years old, with lower urinary tract symptoms and serum PSA levels of >4 but <15 ng/ml formed the study group. Voided urine samples were collected to target VPAC receptors on malignant cells. All patients underwent mp-MRI. A 12-core transrectal ultrasound-guided prostate biopsy was performed in all, and the results were compared for the diagnosis of PCa.

Results: A total of 61 patients with a median age of 65.33 ± 8.11 years and with a median serum PSA of 9.56 ± 2.78 ng/ml were further evaluated with both urinary biomarker assessment and mp-MRI. Histopathological (HPR) confirmation of PCa was noted in 25 (40.98%) patients and benign prostatic hyperplasia in the remaining 36 (59.01%) patients. Of the 25 patients with histologically proven PCa, the urinary biomarker (VPAC positivity) was positive for malignancy in 24 (96%), one case showed false negative results (4%) and there were no false positive cases (0%). HPR confirming PCa was seen in 3/16 patients with a PIRADS 2 score, 7/21 patients with a PIRADS 3 score, 7/14 patients with a PIRADS 4 score and 8/8 patients with a PIRADS score of 5.

Conclusions: VPAC receptor positivity of prostate cancer cells is an easy test to perform using a voided urine sample. VPAC receptor positivity can be used as an indication for prostate biopsy in patients having a negative previous biopsy but highly suspicious of cancer, in patients with an elevated serum PSA but with a normal digital rectal examination and in patients with benign features and borderline elevation of serum PSA.

Keywords: VPAC receptors; imaging; optical imaging; prostate cancer; urinary assay.