1908 USE OF PROSTATE CANCER GENE 3 (PCA3) IN DETECTING PROSTATE CANCER IN INITIAL AND REPEAT PROSTATE BIOPSY PATIENTS

Abstract

You have accessJournal of UrologyProstate Cancer: Detection and Screening1 Apr 20111908 USE OF PROSTATE CANCER GENE 3 (PCA3) IN DETECTING PROSTATE CANCER IN INITIAL AND REPEAT PROSTATE BIOPSY PATIENTS Roland Goode, Susan Marshall, Eric Chevli, Michael Duff, and K. Kent Chevli Roland GoodeRoland Goode Buffalo, NY More articles by this author , Susan MarshallSusan Marshall Buffalo, NY More articles by this author , Eric ChevliEric Chevli Buffalo, NY More articles by this author , Michael DuffMichael Duff Buffalo, NY More articles by this author , and K. Kent ChevliK. Kent Chevli Buffalo, NY More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2011.02.2046AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Prostate Cancer Gene 3 (PCA3) is over expressed in prostate cancer cells and can be measured with an assay of a sample obtained after an attentive DRE. In recent studies, the specificity of PCA3 has been shown to be higher than PSA in detecting prostate cancer. The objective of this study is to further define the role of PCA3 in patients undergoing an initial or a repeat prostate biopsy. METHODS We retrospectively collected data from male patients with no known history of prostate cancer who had both a PSA and a PCA3 analysis prior to a prostate biopsy. PCA3 was analyzed using the initial voided after a prostate massage. A genetic assay quantified the ratio of PCA3 mRNA to PSA mRNA. A ratio ≥35 was considered positive. Prostate biopsies were obtained from a transrectal ultrasound-guided prostate biopsy with 12 cores. Correlations between PSA, PCA3, and prostate volume were evaluated. Logistic Regression s were used to calculate the area under the receiver operating characteristic (ROC) curve to compare the predictive value of PCA3 compared to PSA. RESULTS 456 men were identified who underwent a prostate biopsy after a PSA and a PCA3 analysis. 289 men had an initial biopsy and 167 had a repeat biopsy. Using Spearman rank correlation coefficient, PCA-3 score was shown to be independent of prostate volume (p=0.162) and PSA level (p=0.959). Using a Kruskal-Wallis test, PCA-3 scores were significantly higher in patients with cancer on prostate biopsy compared to patients with negative biopsy results (p<0.0001). Logistic regression was used to calculate areas under the ROC curve for PCA-3 and PSA. PCA3 showed a significantly higher AUC than PSA (0.726 vs. 0.512; p=0.0001). This difference persisted when examining the initial biopsy subgroup, with PCA3 out-performing PSA (AUC 0.772 vs. AUC=0.552, p<0.0001). Among patients who underwent repeat biopsy, the difference in AUC did not reach significance between PCA3 and PSA (AUC=0.605 vs. AUC=0.249; p=0.2488). CONCLUSIONS In this study, PCA3 score was found to be independent of prostate volume and PSA score and was also shown to have a positive correlation with prostate cancer status. Using logistic regression, PCA3 was a better predictor of prostate cancer than PSA in the total population as well as the initial biopsy population, but failed to achieve significance in the repeat biopsy population. © 2011 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 185Issue 4SApril 2011Page: e763 Advertisement Copyright & Permissions© 2011 by American Urological Association Education and Research, Inc.MetricsAuthor Information Roland Goode Buffalo, NY More articles by this author Susan Marshall Buffalo, NY More articles by this author Eric Chevli Buffalo, NY More articles by this author Michael Duff Buffalo, NY More articles by this author K. Kent Chevli Buffalo, NY More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...