Publication
Schalken JA. Eur Urol Suppl 2009;8:97-102
- This paper reviews publications on Prostate CAncer gene 3 (PCA3) from 1999, when the gene was first described, until now
- PCA3 mRNA is highly over-expressed in more than 90% of prostate tumours (median 66-fold) relative to benign tissue and is highly prostate cancer-specific
- The ProgensaTM PCA3 Assay measures PCA3 and prostate specific antigen (PSA) mRNA concentrations in urine samples taken after a 3-stroke digital rectal examination (DRE). Transcription-mediated amplification (TMA) technology is used to increase the amount of PCA3 and PSA mRNA in the urine sample. The PCA3 Score is then calculated as [PCA3 mRNA]/[PSA mRNA]*1,000.
- The Progensa PCA3 Assay demonstrates good analytical performance with a high informative rate (>95%) and good reproducibility
- Clinical studies showed that the PCA3 Assay has a greater diagnostic accuracy than serum total PSA level or % free PSA for predicting the outcome of a repeat prostate biopsy. The PCA3 Score correlates with the probability of a positive (repeat) biopsy: the probability of a positive biopsy increases continuously as the PCA3 Score increases. The performance of the PCA3 Assay is independent of prostate size, PSA level and number of prior biopsies
- Incorporating the PCA3 Score into multivariate models predicting prostate cancer increases the diagnostic accuracy of these models, showing that PCA3 has the potential to increase diagnostic accuracy when used in conjunction with other patient information. Therefore, the PCA3 Score has the potential to add value when incorporated into existing nomograms to further improve the accuracy of prostate cancer diagnosis
- Preliminary data suggest that PCA3 Scores are higher in patients with larger, more invasive tumours Therefore, the PCA3 Score may have prognostic value and could assist in identifying which cancers require more aggressive treatment and which could be managed by active surveillance
- It is concluded that the PCA3 Assay is the first molecular diagnostic assay for prostate cancer cells in biological fluids, and holds promise as a valuable tool for aiding in the diagnosis of prostate cancer!
More information: Article at European Urology Supplements