UroToday - Clinical Utility of the PCA3 Urine Assay in European Men Scheduled for Repeat Biopsy - Abstract

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Monday, 14 July 2008

Department

of Urology, University Clinic Hamburg,

Hamburg, Germany.

The

Prostate CAncer gene 3 (PCA3) assay has shown promise as an aid in prostate

cancer (pCA) diagnosis in identifying men with a high probability of a positive

(repeat) biopsy.

This

study evaluated the clinical utility of the PROGENSA PCA3 assay.

This

European prospective, multicentre study enrolled men with one or two negative

biopsies scheduled for repeat biopsy.

After

digital rectal examination (DRE), first-catch urine was collected to measure

PCA3 mRNA concentration and to calculate the PCA3 score. The PCA3 score was

compared to biopsy outcome. The diagnostic accuracy of the PCA3 assay was

compared to percent of free prostate-specific antigen (%fPSA).

In 463

men, the positive repeat biopsy rate was 28%. The higher the PCA3 score, the

greater the probability of a positive repeat biopsy. The PCA3 score (cut-off of

35) had a greater diagnostic accuracy than %fPSA (cut-off of 25%). The PCA3

score was independent of the number of previous biopsies, age, prostate volume,

and total prostate-specific antigen (PSA) level. Moreover, the PCA3 score was

significantly higher in men with high-grade prostate intraepithelial neoplasia

(HGPIN) versus those without HGPIN, clinical stage T2 versus T1, Gleason score

>/=7 versus <7, and " significant " versus " indolent "

(clinical stage T1c, PSA density [PSAD] <0.15ng/ml, Gleason score in biopsy The probability of a positive repeat biopsy increases with rising PCA3

scores. The PCA3 score was superior to %fPSA for predicting repeat prostate

biopsy outcome and may be indicative of clinical stage and significance of pCa.

Written

by

Haese A, de la Taille A, van Poppel H, Marberger M, Stenzl A, Mulders PF,

Huland H, Abbou CC, Remzi M, Tinzl M, Feyerabend S, Stillebroer AB, van Gils

MP, Schalken JA.

Reference

Eur Urol. 2008 Jun 26. Epub ahead of print.

doi:10.1016/j.eururo.2008.06.071

PubMed

Abstract

PMID:18602209