The Urinary Sarcosine/Creatinine Ratio is a Potential Diagnostic and Prognostic Marker in Prostate Cancer

Abstract

BACKGROUND The aim of this study was to evaluate the role of the urinary sarcosine/creatinine ratio in the diagnosis and prognosis of prostate cancer, using a sarcosine oxidase assay. MATERIAL AND METHODS Urine samples were obtained from 203 patients with benign prostate hyperplasia (BPH) and 209 patients with prostate cancer. Levels of urinary sarcosine were measured using the sarcosine oxidase method. The urinary sarcosine/creatinine ratios were compared between the group of patients with BPH and the patients with prostate cancer. In the two patients groups, the urinary sarcosine/creatinine ratio was compared with the measurement of serum prostate-specific antigen (PSA) and the free/total (F/T) PSA ratio. Correlations between of the urinary sarcosine/creatinine ratio and the Gleason grade and stage of prostate cancer were analyzed. RESULTS There was a significant difference between the urinary sarcosine/creatinine ratio in the BPH group and prostate cancer group (P<0.01), which was independent of serum PSA. The receiver-operating characteristic (ROC) curve, and area under the curve (AUC) for the urinary sarcosine/creatinine ratio was significantly higher compared with the serum PSA and the F/T PSA ratio. There was a significant difference in the urinary sarcosine/creatinine ratio in patients with prostate cancer with Gleason score ≤6, 7, and ≥8, and between patients with metastatic and non-metastatic prostate cancer. CONCLUSIONS The urinary sarcosine/creatinine ratio was a diagnostic indicator of prostate cancer, for patients with a serum PSA level <10 ng/ml, and correlated with the Gleason score and with the presence of metastases (stage) of prostate cancer.