Abstract
Background: The widespread acceptance of serum PSA testing for the early detection of prostate cancer has been hampered by the low specificity and unnecessary biopsies. Methods: This study was carried out to detect prostate cancers in patients with equivocal PSA values using RT-PCR (Reverse transciptase- polymerase chain reaction) to detect the uPM3 (urinary protein M3) in post prostatic massage urine samples. uPM3 is a mRNA released in prostate cancer patients due to the presence of the oncogene DD3 also called as PCA3 on chromosome 9. Results: There were a total of 27 cases of prostate carcinoma and 33 cases of PIN (prostate intraepithelial neoplasia) detected in this study. The sample collection accuracy depending on presence of beta2 microglobulin (housekeping gene) band was 88%. The sensitivity and specificity of uPM3 keeping histopathology as gold standard was 85.18% and 98.78% respectively. Positive predictive value was 88.46% and negative predictive value was 98.38% which is much higher than PSA. However, no significant correlation of uPM3 positivity was found with Gleason’s grade, metastatic potential and pathological stage. Conclusion: Unlike serum PSA, uPM3 was found to be independent of prostate volume thereby having no false positives unlike raised PSA because of large benign prostate hypertrophy.
Highlights
Prostate cancer incidence has been increasing in India
Manuscript received: 26th December 2016 Reviewed: 1st January 2017 Author Corrected: 6th January 2017 Accepted for Publication: 12th January 2017 serum Prostate Specific Antigen (PSA) levels are regularly elevated in men with BPH (Benign Prostate Hypertrophy), prostatitis, and other non-malignant disorders, resulting in reduced specificity [3]
Inclusion Criteria & Sample Collection- All the symptomatic patients of prostatomegaly reporting to the urology clinic were included in the study.These patients after initial digital rectal examination (DRE) reported to the hospital laboratory
Summary
Prostate cancer incidence has been increasing in India. The outlook for prostate cancer has considerably changed in the last decade. Though uncommon in Asian countries, the incidence is increasing in our country It ranks 5th in incidence and 4th in cancer mortality for men as per a study conducted in Mumbai [1]. A significant contribution to the early detection of prostate cancer has been the detection of Prostate Specific Antigen (PSA) and subsequent development of various immunological assays in serum. The widespread acceptance of serum PSA testing for the early detection of prostate cancer has been hampered by the low specificity and unnecessary biopsies. Methods: This study was carried out to detect prostate cancers in patients with equivocal PSA values using RT-PCR (Reverse transciptase- polymerase chain reaction) to detect the uPM3 (urinary protein M3) in post prostatic massage urine samples. Conclusion: Unlike serum PSA, uPM3 was found to be independent of prostate volume thereby having no false positives unlike raised PSA because of large benign prostate hypertrophy
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