# Detection of Prostate Carcinoma in an Asymptomatic Individual Initiated by an Immunological Biopsy—A Case Report

## TL;DR

A blood test combined with MRI helped detect early-stage prostate cancer in a man with no symptoms, showing promise for early diagnosis.

## Contribution

A novel blood test using TKTL1 and Apo10 biomarkers enabled early prostate cancer detection in an asymptomatic individual.

## Key findings

- Elevated TKTL1 and Apo10 levels led to MRI detection of suspicious prostate lesions.
- The lesions were confirmed as early-stage prostate cancer with favorable prognosis.
- The combination of blood test and imaging proved effective for localized cancer detection.

## Abstract

With a total of 1.46 million new cases and 396,792 deaths in 2022, prostate cancer is a major medical challenge around the world. Detecting and treating cancer at earlier, preferably localized stages can significantly increase survival rates. Here, a novel blood-based cancer screening as a pre-test in combination with targeted MRI imaging enabled the early diagnosis of prostate cancer.

We present the case of a 64-year-old man who participated in a prospective, interventional, multicenter cancer screening study where an immunological biopsy-based technique served as a part of a novel screening technique. This immunology technique represents a blood test exploiting two biomarkers, which may allow for the identification of individuals at an early stage of tumor development. Due to the elevated biomarker levels of Transketolase-like protein 1 (TKTL1) and Apoptoic-associated cell population 10 (Apo10), magnetic resonance imaging (MRI) was indicated for further clarification. A multiparametric MRI of the pelvis/prostate revealed an enlarged prostate gland and several suspicious lesions classified as Prostate Imaging Reporting and Data System (PI-RADS) 4 and PI-RADS 5. In further assessments, both lesions were categorized as an acinar adenocarcinoma of the prostate (Gleason Score 6, International Society of Urological Pathology (ISUP) 1, no perineural infiltration). After surgical resection, the tumor was classified histopathologically as an adenocarcinoma, pT2c pN0 (0/7), L0, V0, Pn1, R0, Gleason score 7a, ISUP 2.

The combination of the TKTL1/Apo10 blood test and subsequent imaging made it possible to detect a developing prostate carcinoma in a localized stage. All in all, this case report proves not just the ability but also the potential of the TKTL1/Apo10 blood test for early detection of (pre-)malignant lesions, which still present with a promising prospect for a cure.