ORIGINAL RESEARCH article
Front. Oncol.
Sec. Surgical Oncology
AMACR and ZFPL1 Serum Biomarkers Enhance Precision in Predicting Postoperative Prostate Cancer Outcomes
Provisionally accepted
- 1Qilu Hospital of Shandong University (Qingdao), Qingdao, China
- 2Jinan Seventh People’s Hospital, Jinan, China
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Background: Prostate cancer (PCa) remains a major clinical challenge, with postoperative recurrence risk varying substantially among patients. Emerging evidence suggests that serum biomarkers, including α-methylacyl-CoA racemase (AMACR) and zinc finger protein-like 1 (ZFPL1), may provide additional prognostic information beyond conventional clinicopathological factors. Materials and Methods: This single-center retrospective study included 115 patients with PCa who underwent radical prostatectomy. Serum AMACR and ZFPL1 levels were analyzed in combination with clinicopathological variables. Univariate and multivariate logistic regression analyses were performed to identify independent predictors of recurrence. A risk nomogram was constructed, and model performance was evaluated using receiver operating characteristic (ROC) curve analysis and Kaplan–Meier survival analysis. Results: Poor postoperative outcomes were significantly associated with advanced age, lymph node metastasis, higher TNM stage, poor tumor differentiation, and higher Gleason score. Serum AMACR and ZFPL1 levels were significantly elevated in patients who experienced recurrence. Multivariate analysis identified both biomarkers as independent predictors of recurrence. The resulting nomogram demonstrated strong discriminative performance and stable predictive accuracy across multiple postoperative time points. Conclusion: Elevated serum AMACR and ZFPL1 levels independently predict recurrence following radical prostatectomy in patients with PCa. The proposed nomogram integrates molecular and clinicopathological factors to provide accurate postoperative risk stratification, supporting individualized follow-up and management, with robust performance observed up to 3 years after surgery.
Keywords: Postoperative prognosis, Prediction model, prostate cancer, Risk Assessment, Zinc FingerProtein-Like 1, α-Methylacyl-CoA racemase
Received: 09 May 2025; Accepted: 22 Jan 2026.
Copyright: © 2026 Yang, Lv, Liu, Chen and Gu. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Gangli Gu
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