# Prediction of Bone Metastasis in Prostate Cancer Using Blood Glucose-6-Phosphate Dehydrogenase Activity: A Retrospective Medical Record Review

## TL;DR

This study shows that blood G6PD activity can help predict bone metastasis in prostate cancer patients, offering a non-invasive tool for early detection.

## Contribution

The study identifies G6PD activity as a novel non-invasive biomarker for predicting bone metastasis in prostate cancer.

## Key findings

- Median G6PD activity was significantly higher in patients with bone metastasis.
- The AUC for G6PD activity in predicting bone metastasis was 0.78 (95% CI, 0.66–0.90).
- An optimal cutoff value of 11.5 U/g Hb was determined with 81% sensitivity and 73% specificity.

## Abstract

Prostate cancer is the most common diagnosed cancer among men in the United States. Bone is the predominant metastatic site in prostate cancer, and bone metastases occur in more than 80% of patients with castration-resistant prostate cancer. Accurate and early prediction of bone metastasis in prostate cancer is crucial for deciding treatment decisions. This study aimed to evaluate the potential of G6PD activity level as a biomarker for predicting bone metastasis in patients with prostate cancer. We revealed fair diagnostic performance of G6PD activity and calculated optimal cutoff value of G6PD activity level. The results support value of G6PD activity as a non-invasive marker for metastatic risk assessment. We suggest that serial monitoring of G6PD activity may help assess the risk of bone metastasis and enable early detection in patients with prostate cancer.

Background: Globally, the incidence of prostate cancer is estimated to increase by approximately 80% by 2040 compared to 2018. Bone is the most common metastatic site in prostate cancer and accurate prediction of bone metastasis in prostate cancer is crucial for deciding treatment decisions. The aim of this study is to evaluate the potential of G6PD activity level as a biomarker for predicting bone metastasis in patients with prostate cancer. Methods: A total of 56 patients participated in this study and participants included in the study were prostate cancer patients aged 19 years or older who visited YCH Hospital. We compared G6PD activity levels according to presence of bone metastasis. Also, ROC analysis was conducted to evaluate the predictive performance of G6PD activity level for bone metastasis. Optimal cutoff value of G6PD activity level was determined using Youden’s index and corresponding sensitivity and specificity were calculated. Results: The median G6PD activity was significantly higher in the group with bone metastasis than in the group without bone metastasis. According to ROC curve analysis, the area under the curve (AUC) was 0.78 (95% CI, 0.66–0.90). The optimal cutoff value of G6PD activity level for predicting bone metastasis was determined to be 11.5 U/g Hb. At this cutoff value, sensitivity and specificity were 0.81 and 0.73, respectively. Conclusions: G6PD activity is a complementary non-invasive biomarker for predicting bone metastasis in patients with prostate cancer.