Plasma infrared molecular fingerprinting for prostate cancer detection: Prospective evidence for a partially PSA-independent signal
Abstract
BACKGROUND: Prostate-specific antigen (PSA) testing has limited specificity, particularly at intermediate concentrations, contributing to diagnostic uncertainty in prostate cancer (PCa). Infrared molecular fingerprinting (IMF) provides a rapid plasma-based readout of systemic biochemical variation and may capture PCa-associated molecular information not fully reflected by PSA.
METHODS: In the prospective Lasers4Life study, plasma from 2024 men was analysed, including 1012 treatment-naïve PCa patients, 752 men with benign prostatic hyperplasia (BPH), and 260 asymptomatic controls. Classification models were evaluated using cross-validation and, for PCa-versus-BPH discrimination, temporally independent held-out testing. Performance was quantified by receiver operating characteristic area under the curve (ROC AUC) and examined across PSA strata, comorbidities, and medications.
RESULTS: IMF discriminated PCa from asymptomatic controls more strongly than from BPH, with cross-validated AUCs of 0.79 ± 0.08 and 0.67 ± 0.04, respectively. In an exploratory age- and PSA-matched subset of men with PSA below 12 ng/mL, comprising 200 PCa and 200 BPH cases, IMF showed higher discrimination than PSA alone, although performance remained modest (AUC 0.63 vs 0.56; p < 1 ×10⁻⁴). Most examined comorbidities and medications did not substantially alter IMF performance, although prostatitis reduced discrimination.
CONCLUSIONS: Plasma IMF detected PCa-associated variation in a pre-treatment…
How strong is the evidence?
Evidence Hub reads this as a case-control, done in people. Its evidence level is 4 of 5 (Low · observational). Observational designs can show an association but not prove cause. Reported size: 752 participants or records.
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