Abstract
It has been suggested that urinary PCA3 and TMPRSS2:ERG fusion tests and serum PHI correlate to cancer aggressiveness-related pathological criteria at prostatectomy. To evaluate and compare their ability in predicting prostate cancer aggressiveness, PHI and urinary PCA3 and TMPRSS2:ERG (T2) scores were assessed in 154 patients who underwent radical prostatectomy for biopsy-proven prostate cancer. Univariate and multivariate analyses using logistic regression and decision curve analyses were performed. All three markers were predictors of a tumor volume ≥0.5 mL. Only PHI predicted Gleason score ≥7. T2 score and PHI were both independent predictors of extracapsular extension (≥pT3), while multifocality was only predicted by PCA3 score. Moreover, when compared to a base model (age, digital rectal examination, serum PSA, and Gleason sum at biopsy), the addition of both PCA3 score and PHI to the base model induced a significant increase (+12%) when predicting tumor volume >0.5 mL. PHI and urinary PCA3 and T2 scores can be considered as complementary predictors of cancer aggressiveness at prostatectomy.
Highlights
Prostate-Specific Antigen (PSA) assay is not recommended for prostate cancer (PCa) screening, it is largely used for early detection and contributes to increase the incidence of PCa
Since the first report based on prostatectomy specimens [23], correlation between Prostate cancer gene 3 (PCA3) score and tumor volume has been confirmed by subsequent studies [24,25,26,27]
While tumor volume is predicted by both PCA3 and T2 scores and Prostate Health Index (PHI), the three tests predict different characteristics, PCA3 score being indicative of multifocality, T2 score of extracapsular extension and PHI of Gleason sum
Summary
Prostate-Specific Antigen (PSA) assay is not recommended for prostate cancer (PCa) screening (review in [1]), it is largely used for early detection and contributes to increase the incidence of PCa. Prostate cancer gene 3 (PCA3), TMPRSS2:ERG gene fusion and PHI are among the most promising biomarkers that could complement PSA for early PCa diagnosis. The subsequent overexpression of the TMPRSS2:ERG transcript (in situ hybridization or RT-PCR) is reported as highly specific for the presence of cancerous tissue in prostate tissue-based studies [8,9]. Since the first report based on prostatectomy specimens [23], correlation between PCA3 score and tumor volume has been confirmed by subsequent studies [24,25,26,27]. A recent study reported a correlation between PHI and GS, pT stage and tumor volume [36]. GS, low tumor volume, multifocality and extracapsular extension at final pathology
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
