PCA3 Materials & News

Vlaeminck-Guillem V, Devonec M, Colombel M, Rodriquez-Lafrasse C, Decaussin-Petrucci M, Ruffion A. J Urol 2011;185:1234-9

• This single-centre study in 102 men undergoing radical prostatectomy shows that the PCA3 Score correlates with tumour volume, apical and basal invasion of the prostate  and bilaterality and multifocality of prostate cancer (PCa)
• This French, prospective, single-centre study included 102 men with an informative PCA3 Score who underwent radical prostatectomy
• The PCA3 Score correlated positively with total tumour volume (Figure 1) and volume of the main tumour at prostatectomy (each P<0.001)
• The mean PCA3 Score was statistically significantly lower in men with unifocal disease (46) compared to men with multifocal disease (88; P=0.007; Figure 2)
• In a multivariate analysis, the PCA3 Score was a significant predictor of cancer multifocality while serum PSA, % free PSA, prostate volume, clinical stage and biopsy Gleason score were not
• The PCA3 Score was significantly lower in men with unilateral PCa compared to men with bilateral PCa
• The PCA3 Score correlated with cancer invasion of the apex and base of the prostate and resection margins
• The PCA3 Score did not correlate with pathological Gleason score and pathological stage
• The PCA3 Score was independent of prostate volume, total PSA and % free PSA. In contrast, total serum PSA was dependent of prostate volume
• It was discussed that the factors which influence the shedding of PCa cells containing PCA3 mRNA in the urine should be further evaluated. Tumour volume is likely to be such a factor and this study demonstrates that apical and basal invasion of the prostate and multifocality and bilaterality of PCa might also influence the shedding of PCa cells containing PCA3 mRNA into the urine. For example, multifocal cancers are more likely to shed PCa cells containing PCA3 mRNA in the urine since it is more likely that at least 1 focus containing PCa cells is located near the ductal system. However, this should be further evaluated in larger studies
• It was concluded that the PCA3 Score is associated with tumour volume, apical and basal invasion of the prostate, bilaterality and multifocality of PCa. Multifocality is an independent predictor in multivariate analysis. Although the relationship between PCA3 and unilateral and/or unifocal cancer should be further evaluated in larger studies, this study suggests that the PCA3 Score may aid in selecting patients suitable for active surveillance or focal therapy

Figure 1: The PCA3 Score is statistically significantly lower in men with a low total tumour volume vs. a high tumour volume

 Figure 2: The PCA3 Score is significantly lower in men with unifocal PCa compared to men with multifocal PCa

More information: Article at PubMed