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3) Compared with PSA testing, a significant advantage of TMPRSS2:ERG fusion testing is that the ETS gene fusions are specific for neoplastic cells, which is important because prostate cancer tends to be overdiagnosed, partly because of the low specificity of PSA as a screening tool.
Expression of the TMPRSS2:ERG fusion gene predicts cancer recurrence after surgery for localised prostate cancer.
They wrote: "The TMPRSS2:ERG fusion, detected in approximately 50% of prostate cancers, is the most common fusion gene found in human malignancies.
Noninvasive detection of TMPRSS2:ERG fusion transcripts in the urine of men with prostate cancer.
TMPRSS2:ERG fusion transcripts in urine from prostate cancer patients correlate with a less favorable prognosis.
Detection of TMPRSS2:ERG fusion gene in circulating prostate cancer cells.
Absence of TMPRSS2:ERG fusions and PTEN losses in prostate cancer is associated with a favorable outcome.
Based on these findings, a urinary assay for TMPRSS2:ERG fusion (T2:ERG) is currently in development using the same platform and technology as the PCA3 assay (18).
Urine TMPRSS2:ERG fusion transcript integrated with PCA3 score, genotyping, and biological features are correlated to the results of prostatic biopsies in men at risk of prostate cancer.
We (5) have recently reported a direct analysis of the expression of the TMPRSS2:ERG fusion gene in surgical samples from a total of 84 patients, 24 of whom had received presurgery androgen ablation therapy.
Hermans et al (3) have suggested and have provided some evidence that tumors in which the TMPRSS2:ERG fusion gene is not expressed are able to overexpress instead another transcription factor of the erythroblast transformation-specific family.
Seventeen different types of TMPRSS2:ERG fusion transcripts involving various regions of the TMPRSS2 and ERG genes have been identified (86,99-102); however, 8 of these transcripts are unlikely to result in the translation of functional ERG proteins due to the introduction of premature stop codons.