Abstract
BackgroundProstate Cancer 3 (PCA3) is a long non-coding RNA (ncRNA) upregulated in prostate cancer (PCa). We recently identified a short ncRNA expressed from intron 1 of PCA3. Here we test the ability of this ncRNA to predict the presence of cancer in men with a biopsy without PCa.MethodsWe selected men whose initial biopsy did not identify PCa and selected matched cohorts whose subsequent biopsies revealed PCa or benign tissue. We extracted RNA from the initial biopsy and measured PCA3-shRNA2, PCA3 and PSA (qRT-PCR).ResultsWe identified 116 men with and 94 men without an eventual diagnosis of PCa in 2–5 biopsies (mean 26 months), collected from 2002–2008. The cohorts were similar for age, PSA and surveillance period. We detected PSA and PCA3-shRNA2 RNA in all samples, and PCA3 RNA in 90% of biopsies. The expression of PCA3 and PCA3-shRNA2 were correlated (Pearson’s r = 0.37, p<0.01). There was upregulation of PCA3 (2.1-fold, t-test p = 0.02) and PCA3-shRNA2 (1.5-fold) in men with PCa on subsequent biopsy, although this was not significant for the latter RNA (p = 0.2). PCA3 was associated with the future detection of PCa (C-index 0.61, p = 0.01). This was not the case for PCA3-shRNA2 (C-index 0.55, p = 0.2).ConclusionsPCA3 and PCA3-shRNA2 expression are detectable in historic biopsies and their expression is correlated suggesting co-expression. PCA3 expression was upregulated in men with PCa diagnosed at a future date, the same did not hold for PCA3-shRNA2. Futures studies should explore expression in urine and look at a time course between biopsy and PCa detection.
Highlights
Prostate cancer (PCa) is the most common male cancer in the western world [1]
Prostate Cancer 3 (PCA3) and PCA3-shRNA2 expression are detectable in historic biopsies and their expression is correlated suggesting co-expression
PCA3 expression was upregulated in men with PCa diagnosed at a future date, the same did not hold for PCA3-shRNA2
Summary
Prostate cancer (PCa) is the most common male cancer in the western world [1]. Detection usually occurs through the identification of men at elevated risk, through serum PSA measurement, MRI or family history, and prostate biopsy (PBx) [2]. Whilst biopsy is a well tolerated procedure usually conducted in the out patient setting, it carries considerable risks of low severity morbidity [3]. Patients without cancer in their initial biopsy and persistently elevated PSA levels are difficult to manage. Whilst 10–30% have undetected PCa [4, 5], automatic repeat PBx (rptPBx) represents over-investigation for many and carries the risks of additional procedures.
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