Publication
Schilling D, Hennenlotter, Munz M, Bökeler U, Sievert K-D, Stenzl A. Urol Int 2010;85:159-65
- This single-centre retrospective study in 32 selected men undergoing a biopsy shows that a high PCA3 Score corresponds with a high probability of a positive biopsy. In daily practice, the PCA3 Score constitutes a valuable addition to prostate specific antigen (PSA) and other clinical variables and can help to guide the decision for or against a prostate biopsy
- Data from 104 consecutive men selected for receiving a PCA3 Assay between January-June 2008 were retrospectively reviewed; 47 had a PCA3 Score ≥ 35. In 32 men with a PCA3 Score ≥ 35 and/or at risk of prostate cancer based on DRE (digital rectal examination) and PSA level a biopsy (median 10 cores) was performed; 14 of these had at least one prior negative biopsy
- The informative rate (percentage of urine samples containing sufficient PSA and PCA3 mRNA for calculation of PCA3 Score) was 99%
- The PCA3 Score was not correlated with total serum PSA level, prostate volume or volume of collected urine sample
- The positive biopsy rate was 56% in the whole cohort and 57% in men with a prior negative biopsy, reflecting the inclusion of men at high risk of prostate cancer
- Men with a positive biopsy had a statistically significantly higher PCA3 Score than men with a negative biopsy (Figure)
- At a PCA3 Score cut-off of 35 the sensitivity, specificity, negative predictive value (NPV) and positive predictive value (PPV) of the PCA3 Assay for predicting biopsy outcome was 94%, 36%, 83% and 65%
- The area under the receiver operating characteristic curve (AUC ROC) was higher for the PCA3 Score (0.81) compared to that of serum total PSA (0.61)
- It was discussed that major drawbacks of this retrospective study were the inclusion of men at high risk of prostate cancer (median PSA 7.7 ng/mL) and the limited number of men undergoing biopsy (n=32). The sensitivity and specificity of the PCA3 test in this study differed somewhat from that in prior studies which may also be due to the high positive biopsy rate, choice of PCA3 threshold value, and/or laboratory effects
- It was concluded that the PCA3 Assay is a prostate cancer-specific urine assay which can be easily implemented in daily practice. It constitutes a valuable addition to PSA and other clinical variables and can help to guide the decision for performing a prostate biopsy
More information: Article at PubMed