Test urinaire PCA3, cancer de la prostate et autres pathologies prostatiques

Abstract

Summary Urinary PCA3 test became one of the most developed biological examinations to facilitate, in association with blood PSA, early diagnosis of prostate cancer. Clinical studies demonstrated its interest when deciding prostate biopsies in all situations in which seric PSA reveals inaccurate. It particularly offers a better specificity when orienting patients to biopsy. Non-cancerous prostate diseases, such as benign prostate hyperplasia (BPH) and prostatitis, can induce an increase in seric PSA. In these conditions, urinary PCA3 score doesn’t increase and conserves its discriminative properties of prostate cancer biomarker. Neither BPH nor prostatitis constitute a contra-indication for the test and an increase in PCA3 score cannot be explained by one or the other, therefore resulting in prostate biopsy. Likewise, treatment by 5α-reductase inhibitor doesn’t influence PCA3 score. Precancerous lesions can be associated with an increase in PCA3 score, usually less marked than in case of prostate cancer.