Plasma Exosomal RNA Signature for Prostate Cancer Bone Metastasis

Inclusion Criteria 1. Patients with histologically confirmed prostate cancer who are scheduled to undergo baseline PSMA PET imaging. 2. Patients who undergo PSMA PET imaging prior to any prostate cancer-related treatment (including androgen deprivation therapy, radiotherapy, or surgery). 3. Patients who provide blood samples for plasma exosomal RNA analysis collected prior to any treatment AND prior to prostate biopsy (if applicable). Whole blood samples (approximately 10 mL) will be collected in EDTA tubes at this specified time point. Samples will be processed within 2 hours to obtain plasma and stored at -80°C until analysis.This timing ensures circulating exosomal RNA profiles reflect tumor biology without biopsy-induced contamination. 4. Patients who are willing to undergo prostate biopsy if clinically indicated (biopsy performed after blood collection). 5. Patients who provide written informed consent to participate in the study. 6. Age ≥18 years. Exclusion Criteria 1. Patients who have received any prior prostate cancer-related treatment before the baseline PSMA PET scan (including hormonal therapy, radiotherapy, chemotherapy, or surgery). 2. Patients whose blood samples were collected after prostate biopsy. 3. Patients with a history of other active malignancies within the past two years (excluding non-melanoma skin cancer). 4. Patients with inadequate blood sample quality or quantity for exosomal RNA extraction and analysis (e.g., hemolysis, insufficient volume \<8 mL). 5. Patients with severe comorbidities or conditions that, in the judgment of the investigator, could interfere with study compliance or pose significant risk.