Plasma GDF15 Shows Diagnostic Potential in Biopsy-Indicated Prostate Cancer Cohort

The study authors note in their background section that prostate-specific antigen has limited specificity in prostate cancer screening, highlighting the need for novel circulating biomarkers to improve diagnostic accuracy. An observational study published in BMC Urology reports that plasma growth differentiation factor 15, or GDF15, achieved an area under the receiver operating characteristic curve of 0.805 for distinguishing biopsy-confirmed prostate cancer from non-cancer patients in a biopsy-indicated cohort, and a nomogram incorporating GDF15 with age, BMI and tPSA reached AUCs of 0.887 and 0.874 in training and validation cohorts.

The research team, led by Jian Yang, Li Zhang and colleagues at collaborating urology departments, enrolled 312 patients who were hospitalized for prostate-related conditions and scheduled to undergo prostate biopsy. Rather than comparing cancer patients with healthy volunteers, the investigators deliberately constructed a clinically realistic control group: the 180 patients without pathological evidence of prostate cancer all had benign prostatic conditions that independently justified biopsy. The remaining 132 patients had biopsy-confirmed prostate cancer. The non-prostate cancer group consisted of biopsy-indicated patients with benign prostatic conditions rather than healthy controls.

To nominate candidate biomarkers, the researchers performed preliminary proteomic screening of TiO₂-enriched plasma fractions. The diagnostic performance of these candidates was subsequently evaluated by enzyme-linked immunosorbent assay in unfractionated plasma from the main biopsy-indicated cohort.

The ELISA results showed that plasma levels of both GDF15 and secretory leukocyte protease inhibitor, known as SLPI, were significantly higher in the prostate cancer group than in the non-cancer group, with P values below 0.001. Multivariate analysis demonstrated that GDF15 and SLPI were independently associated with prostate cancer risk.

ROC analysis showed that GDF15 achieved an area under the curve of 0.805. The study authors note in their background section that PSA has limited specificity in prostate cancer screening, which is precisely the gap that novel circulating biomarkers like GDF15 are intended to close.

A nomogram prediction model was subsequently constructed. The model incorporated GDF15, age, body mass index and total prostate-specific antigen, and it demonstrated strong predictive performance with AUCs of 0.887 in the training cohort and 0.874 in the validation cohort.

Several important limitations temper the enthusiasm. The authors acknowledge that the limited number of patients with tPSA levels of 4–10 ng/mL precluded reliable subgroup analysis in this clinically important range. The authors also characterize their nomogram performance as favorable internal diagnostic performance, and they call for further validation in larger cohorts before the model can be considered ready for external clinical use.

This observational study enrolled patients hospitalized in the urology department for prostate-related conditions who were scheduled to undergo prostate biopsy. Patients were classified according to biopsy pathology into prostate cancer and non-prostate cancer groups; the latter consisted of biopsy-indicated patients with benign prostatic conditions rather than healthy controls. The article was published under open access on 22 October 2026 and is being shared early as a peer-reviewed, accepted version that remains subject to further edits.

For now, the 0.805 AUC for GDF15 alone and the 0.887 training-cohort AUC for the combined nomogram represent promising internal benchmarks that will need to survive the scrutiny of independent external validation before they change clinical practice.

Subject of Research: Diagnostic performance of plasma GDF15 and a predictive nomogram for prostate cancer detection in a biopsy-indicated cohort

Article Title: Evaluation of plasma GDF15 and a predictive nomogram for prostate cancer diagnosis

Article References: Yang, J., Zhang, L., Zeng, K., Huang, Y., Li, X., Deng, K., Zeng, S., Ye, J., Yang, K., Weng, Y., & Tan, X. (2026). Evaluation of plasma GDF15 and a predictive nomogram for prostate cancer diagnosis. BMC Urology. https://doi.org/10.1186/s12894-026-02444-3

Image Credits: AI Generated

DOI: 10.1186/s12894-026-02444-3

Keywords: prostate cancer, GDF15, biomarker, PSA, nomogram, ROC analysis, ELISA, proteomics, SLPI, diagnostic accuracy, BMC Urology, biopsy