Publication
Wang R, Chinnaiyan AM, Dunn RL, Wojno KJ, Wei JT. Cancer 2009;115:3879-86
- This study in 187 men undergoing a biopsy shows that Prostate CAncer gene 3 (PCA3), combined with serum prostate specific antigen (PSA), improves prostate cancer (PCa) detection, compared to serum PSA alone
- This study was performed in 187 men (mean age 62 years and mean prostate volume 59 g) undergoing a first (73%) or a repeat (27%) 12-core biopsy for an elevated PSA level (in 89% of cases; mean PSA 8.7 ng/mL) in a urology outpatient clinic
- The positive biopsy rate was 46.5%
- The PCA3 Assay was very robust with an informative rate of 97.4%
- The PCA3 Score (cut-off 35) displayed good sensitivity (52.9%) and specificity (80%) for detecting PCa. The positive predictive value was 69.7% and the negative predictive value 66.1%
- The area under the receiver-operating characteristic curve (AUC ROC) for PCa detection for PSA and PCA3 combined was 0.71, which was higher than that for PSA alone (0.63). This demonstrates that adding PCA3 to PSA improves PCa detection
- Logistic regression analysis showed that PCA3 was independently associated with a positive biopsy (P=0.001) after adjusting for the effect of PSA. In addition, PCA3 remained a statistically significant predictor of a positive biopsy after adjusting for age, family history, number of prior biopsies, digital rectal examination (DRE) outcome and PSA. When separating initial from repeat biopsy it was shown that PCA3 was a statistically significant predictor of a positive initial biopsy
- The probability of PCa detection rose with increasing PCA3 Scores and PCA3 Score ranges. This may allow stratification of patients according to their risk of biopsy and prostate cancer detection
- There was no relation between PCA3 Score and prostate volume
- It was concluded that the PCA3 may serve as a useful adjunct to PSA to determine the risk for an initial positive biopsy and may be useful in counselling men who are contemplating a repeat biopsy
Editorial comment
This study performed in a urology outpatient clinic confirms other clinical studies in showing that the PCA3 Score has a good diagnostic accuracy and may aid in repeat biopsy decisions.
More information: Article at PubMed