Performance of the prostate cancer antigen 3 (PCA3) gene and prostate-specific antigen in prescreened men: exploring the value of PCA3 for a first-line diagnostic test

European Urology
Monique J RoobolDaphne Hessels

Abstract

The performance characteristics of serum prostate-specific antigen (PSA) as a diagnostic test for prostate cancer (PCa) are poor. The performance of the PCa antigen 3 (PCA3) gene as a primary diagnostic is unknown. Assess the value of PCA3 as a first-line diagnostic test. Participants included men aged 63-75 who were invited for rescreening in the period from September 2007 to February 2009 within the European Randomised Study of Screening for Prostate Cancer, Rotterdam section. Lateral sextant biopsies were performed if the serum PSA value was > or =3.0 ng/ml and/or the PCA3 score was > or =10. Measurements included distribution and correlation of PSA value and PCA3 score and their relation to the number of cases and the characteristics of PCa detected. Additional value of PCA3 was included in men with previous negative biopsy and/or PSA <3.0 ng/ml. In 721 men, all biopsied, 122 PCa cases (16.9%) were detected. Correlation between PSA and PCA3 is poor (Spearman rank correlation: ρ=0.14; p<0.0001). A PSA > or =3.0 ng/ml misses 64.7% of the total PCa that can be detected with the sextant biopsy technique and 57.9% of serious PCa (T2a or higher and/or Gleason grade > or =4, n=19), and 68.2% of biopsies could have been avoided; th...Continue Reading

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Citations

Nov 10, 2011·World Journal of Urology·Luigi MeariniMassimo Porena
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