# Combination of serum TBL1XR1, MFAP5, and PSA as diagnostic biomarkers for prostate cancer

## TL;DR

This study identifies TBL1XR1 and MFAP5 as potential blood-based biomarkers that, when combined with PSA, improve the accuracy of prostate cancer diagnosis.

## Contribution

The study introduces TBL1XR1 and MFAP5 as novel serum biomarkers that enhance the diagnostic accuracy of prostate cancer when combined with PSA.

## Key findings

- TBL1XR1 and MFAP5 are highly expressed in the serum of prostate cancer patients.
- Combining TBL1XR1, MFAP5, and PSA achieves an AUC of 0.939, significantly improving diagnostic accuracy.
- The fPSA/tPSA ratio shows better diagnostic utility than total PSA alone.

## Abstract

•TBL1XR1 and MFAP5 are highly expressed in the serum of patients with PCa.•TBL1XR1 and MFAP5 expression levels are positively related to PSA concentration.•Combination of TBL1XR1, MFAP5 and PSA improves the accuracy of PCa diagnosis.

TBL1XR1 and MFAP5 are highly expressed in the serum of patients with PCa.

TBL1XR1 and MFAP5 expression levels are positively related to PSA concentration.

Combination of TBL1XR1, MFAP5 and PSA improves the accuracy of PCa diagnosis.

Advanced prostate cancer (PCa) remains a leading cause of cancer-related mortality in men. While Prostate-Specific Antigen (PSA)-based early screening has demonstrated mortality reduction, its diagnostic accuracy remains limited. This study aimed to evaluate the potential of serum transducin (beta)-like-1 X-linked Receptor-1 (TBL1XR1) and Microfibrillar-Associated Protein-5 (MFAP5) as novel diagnostic biomarkers for supplementing PSA-based detection.

Through bioinformatic analysis, TBL1XR1 and MFAP5 were identified as candidate markers, with their expression validated using reverse transcription-quantitative polymerase chain reaction. Diagnostic performance was assessed via Receiver Operating Characteristic (ROC) curve analysis, while Pearson correlation coefficients evaluated biomarker associations.

Serum TBL1XR1 and MFAP5 levels were elevated in PCa patients, both exhibiting positive correlations with PSA concentrations. Individual AUC values reached 0.8197 (TBL1XR1) and 0.8139 (MFAP5). The free PSA (fPSA)/total PSA (tPSA) ratio showed decreased values in PCa cases, demonstrating superior diagnostic utility compared to total PSA alone. A combined panel of TBL1XR1, MFAP5, and PSA achieved an AUC of 0.939 with a Youden index of 0.756.

TBL1XR1 and MFAP5 have the potential for PCa diagnosis. The synergistic application of TBL1XR1, MFAP5, and PSA significantly enhances diagnostic accuracy. These findings indicate that serum TBL1XR1 and MFAP5 represent promising diagnostic markers for PCa. The combination of serum TBL1XR1 and MFAP5 with PSA for diagnosis may potentially reduce unnecessary biopsies in clinical practice.