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This study tested whether circulating tumour DNA (ctDNA) methylation markers improve detection and risk stratification throughout the PCa disease continuum. Using plasma from 280 PerPros participants with suspected PCa, five methylated CpG regions were measured by multiplex ddPCR and assessed with ROC analysis and logistic regression. The ctDNA panel detected methylation across the spectrum, discriminated metastatic castration-sensitive PCa from controls (AUC 0.88), and improved separation of mCSPC from locally advanced disease when combined with PSA, while performance in localized disease was limited.",{"@graph":69,"@context":123},[70,84,106],{"@type":71,"itemListElement":72},"BreadcrumbList",[73,77,79,82],{"item":74,"name":75,"@type":76,"position":8},"https://docshare.wps.com","Home","ListItem",{"item":78,"name":9,"@type":76,"position":14},"https://docshare.wps.com/document/",{"item":80,"name":35,"@type":76,"position":81},"https://docshare.wps.com/document/healthcare/",3,{"item":83,"name":65,"@type":76,"position":19},"https://docshare.wps.com/document/evaluation-of-a-methylated-circulating-tumour-dna-panel-for-detection-and-disease-stratification-in-prostate-cancer/360910/",{"url":83,"name":65,"@type":85,"image":86,"author":91,"headline":65,"publisher":94,"fileFormat":97,"inLanguage":63,"description":67,"dateModified":98,"datePublished":99,"encodingFormat":97,"isAccessibleForFree":100,"interactionStatistic":101},"DigitalDocument",{"url":87,"@type":88,"width":89,"height":90},"https://docshare.wps.com/thumbnails/evaluation-of-a-methylated-circulating-tumour-dna-panel-for-detection-and-disease-stratification-in-prostate-cancer/360910.png","ImageObject",300,407,{"name":92,"@type":93},"Guten tag","Person",{"url":74,"name":95,"@type":96},"DocShare","Organization","application/pdf","2026-10-30","2026-09-23",true,{"@type":102,"interactionType":103,"userInteractionCount":105},"InteractionCounter",{"@type":104},"ViewAction",11,{"@type":107,"mainEntity":108},"FAQPage",[109,115,119],{"name":110,"@type":111,"acceptedAnswer":112},"What was the aim of evaluating the methylated ctDNA panel in prostate cancer?","Question",{"text":113,"@type":114},"To determine whether ctDNA methylation markers can enhance detection and disease risk stratification across the prostate cancer continuum.","Answer",{"name":116,"@type":111,"acceptedAnswer":117},"How were methylation markers measured and which regions were analyzed?",{"text":118,"@type":114},"Five methylated CpG regions (DOCK2, HAPLN3, ACTRT2, EVX1, HOXD13) were analyzed using multiplex ddPCR from plasma samples.",{"name":120,"@type":111,"acceptedAnswer":121},"How did the ctDNA methylation panel perform compared with PSA for distinguishing disease groups?",{"text":122,"@type":114},"The panel discriminated metastatic castration-sensitive PCa from controls (AUC 0.88) and, when combined with PSA, significantly improved discrimination between mCSPC and locally advanced PCa; discrimination for localized disease versus biopsy-confirmed controls was limited.","https://schema.org",{"og:url":83,"og:type":125,"og:title":65,"og:site_name":95,"og:description":67},"article",{"robots":127,"canonical":83},"index,follow",{"doc_id":129,"site_id":62},360910,1790193764,{"code":4,"msg":5,"data":132},{"doc_id":129,"user_id":133,"nickname":92,"user_avatar":134,"doc_module":4,"category_id":34,"category_name":35,"doc_title":65,"doc_description":67,"doc_content":135,"file_id":136,"file_url":137,"file_type":138,"file_size":139,"view_count":105,"is_deleted":4,"is_public":8,"is_downloadable":8,"audit_status":8,"page_count":140,"language":141,"language_code":63,"site_id":62,"html_lang":63,"table_of_contents":142,"faqs":143,"seo_title":144,"seo_description":67,"update_tm":145,"read_time":146},687212321768,"https://ap-avatar.wpscdn.com/avatar/a0010bdbe886d2fe77?x-image-process=image/resize,m_fixed,w_180,h_180&k=1789897067658708522","Article  \nEvaluation of a Methylated Circulating Tumour DNA Panel for Detection and Disease Stratification in Prostate Cancer  \nStine V. Eriksen 1,2, *, Ahmed H. Zedan 1, Søren Kahns 3, Palle J. S. Osther 4, Signe Timm 1 and Torben F. Hansen 1,2  \nAcademic Editor: Whi-An Kwon  \nReceived: 18 May 2026  \nRevised: 3 July 2026  \nAccepted: 5 July 2026  \nPublished: 7 July 2026  \nCopyright: © 2026 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license.  \n1 Department of Oncology, Vejle Hospital, University Hospital of Southern Denmark, 7100 Vejle, Denmark; [ahmed.zedan@rsyd.dk](ahmed.zedan@rsyd.dk) (A.H.Z.); [signe.timm@rsyd.dk](signe.timm@rsyd.dk) (S.T.); [torben.hansen@rsyd.dk](torben.hansen@rsyd.dk) (T.F.H.)  \n2 Department of Regional Health Research, Faculty of Health Sciences, University of Southern Denmark, 5230 Odense, Denmark  \n3 Department of Biochemistry and Immunology, Vejle Hospital, University Hospital of Southern Denmark, 7100 Vejle, Denmark; [soren.kahns@rsyd.dk](soren.kahns@rsyd.dk)  \n4 Department of Urology, Vejle Hospital, University Hospital of Southern Denmark, 7100 Vejle, Denmark; [palle.joern.osther@rsyd.dk](palle.joern.osther@rsyd.dk)  \n* Correspondence: [stine.vestergaard.eriksen@rsyd.dk](stine.vestergaard.eriksen@rsyd.dk)  \nAbstract  \nProstate cancer (PCa) exhibits marked biological heterogeneity, complicating accurate identification of aggressive disease at initial diagnosis. This study investigated whether circulating tumour DNA (ctDNA) methylation markers enhance detection and risk stratification across the PCa disease continuum. Plasma samples from the initial hospital visit were obtained from 280 participants in the PerPros prostate biobank (Vejle, Denmark), all referred with suspected PCa. Following diagnostic work-up, participants were classified across the PCa disease spectrum or as biopsy-confirmed PCa-free controls. Five methylated CpG regions (DOCK2, HAPLN3, ACTRT2, EVX1, HOXD13) were analysed using multiplex ddPCR. Performance was assessed using ROC analysis and logistic regression and compared with prostate-specific antigen (PSA) . Methylation markers were detectable across the PCa disease spectrum, most frequently in metastatic castration-sensitive PCa (mCSPC)(85/97; 88%) . The ctDNA methylation panel discriminated mCSPC from controls with an AUC (area under the curve) of 0.88 (95% CI: 0.83–0.93) . In this cohort, combining PSA (cut-off 20 µg/L) with the ctDNA methylation panel significantly improved discrimination between patients with mCSPC and locally advanced PCa compared with PSA alone (AUC 0.88; 95% CI 0.83–0.94; p \u003C 0.001) vs. 0.78 (95% CI 0.71–0.84) . In contrast, discrimination between localised/locally advanced PCa and patients with biopsy-confirmed controls was limited (AUC 0.56; 95% CI: 0.51–0.61) . The ctDNA methylation panel demonstrates robust identification of metastatic PCa and can effectively differentiate mCSPC from locally advanced PCa. However, its diagnostic abilities in localised disease appear limited.  \nKeywords: prostate cancer; circulating tumour DNA; ctDNA methylation; liquid biopsy; droplet digital PCR  \n1. Introduction  \nProstate cancer (PCa) is the second most diagnosed malignancy among men worldwide, with over 1.4 million new cases each year [1] . Due to the wide variability in disease presentation, ranging from indolent to highly aggressive PCa, outcomes vary markedly  \nacross the disease spectrum. Patients diagnosed with localised PCa generally have longterm survival, whereas those presenting with de novo metastatic disease have a substantially poorer prognosis [2,3] . These differences are driven mainly by the extent of disease at diagnosis. However, considerable heterogeneity in clinical outcomes has also been observed among patients with the same disease stages, reflecting underlying biological and molecular diversity [4] . Conseque","cbCaipsOq254yBBT","https://ap.wps.com/l/cbCaipsOq254yBBT","pdf",1190443,13,"English","# Abstract\n# Keywords\n# 1. Introduction","[{\"question\":\"What was the aim of evaluating the methylated ctDNA panel in prostate cancer?\",\"answer\":\"To determine whether ctDNA methylation markers can enhance detection and disease risk stratification across the prostate cancer continuum.\"},{\"question\":\"How were methylation markers measured and which regions were analyzed?\",\"answer\":\"Five methylated CpG regions (DOCK2, HAPLN3, ACTRT2, EVX1, HOXD13) were analyzed using multiplex ddPCR from plasma samples.\"},{\"question\":\"How did the ctDNA methylation panel perform compared with PSA for distinguishing disease groups?\",\"answer\":\"The panel discriminated metastatic castration-sensitive PCa from controls (AUC 0.88) and, when combined with PSA, significantly improved discrimination between mCSPC and locally advanced PCa; discrimination for localized disease versus biopsy-confirmed controls was limited.\"}]","Evaluation of a Methylated Circulating Tumour DNA Panel for Detection and Disease Stratification in Prostate Cancer | PDF",1790142013,33]