Circulating Long Non-Coding RNA HOX Transcript Antisense RNA (HOTAIR) as a diagnostic and prognostic Biomarker in Prostate Cancer

Gawish, Heba Hassan; Kamel, Mostafa; Khalifa, Naeema Awad Ali; Ahmed Abd El Rahman, Azza Moustafa

doi:10.21608/zumj.2025.397113.4020

Circulating Long Non-Coding RNA HOX Transcript Antisense RNA (HOTAIR) as a diagnostic and prognostic Biomarker in Prostate Cancer

Document Type : Original Article

Authors

¹ Professor of Clinical Pathology, Faculty of Medicine, Zagazig University

² Professor of Urology, Faculty of Medicine, Zagazig University

³ Lecturer of Clinical Pathology, Faculty of Medicine, Zagazig University

⁴ Assistant Professor of Clinical pathology, Faculty of Medicine, Zagazig University

10.21608/zumj.2025.397113.4020

Abstract

Background: Prostate cancer (PCa) is considered the most prevalent non-skin cancer affecting males and remains controversial owing to the limited specificity of Prostate Specific Antigen (PSA) testing. HOX transcript antisense RNA (HOTAIR), as a long non-coding RNA, could serve as a significant biomarker for prognosis and prediction in cancer.

Methods: This case-control study enrolled 60 male patients (20 cases with begin prostatic hyperplasia (BPH) as control group, 20 cases with localized prostate cancer and 20 cases with metastatic prostate cancer). Circulating LncRNA HOTAIR was assessed in plasma by quantitative real-time polymerase chain reaction

Results: Among patients with PSA levels in the 4–10 ng/mL gray zone, HOTAIR was significantly lower in benign cases (1.05 ±0.15) than in localized cancer (3.32 ± 0.43, p = 0.006). Among patients with PSA levels in the 4–10 ng/mL gray zone, HOTAIR was significantly lower in benign cases (1.05 ± 1.15) than in localized cancer (3.32 ± 1.43, p = 0.006). HOTAIR levels positively correlated with total PSA, tumor grade, and Gleason score (all p < 0.001), negatively with prostate volume and free/total PSA ratio (both p < 0.001). ROC analysis revealed combined HOTAIR and PSA achieved high accuracy for differentiating cancer (AUC = 0.997, sensitivity = 100%, specificity = 95%) and detecting metastasis (AUC = 0.994, sensitivity = 100%).

Conclusions: Plasma HOTAIR expression achieved good diagnostic accuracy in discrimination of metastatic PCa from localized PCa and benign conditions suggesting that plasma HOTAIR could act as a novel diagnostic as well as prognostic biomarker for PCa.

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