To evaluate the PCA3 (Prostate Cancer 3 gene) as a tool to improve prostate cancer (PCa) screening and its capability to predict PCa aggressiveness.
A retrospective study with data from consecutive patients with suspected PCa seen in the urology department between November 2009 and April 2016 and who were candidates for prostate biopsy. A total of 1038 urine samples were tested in our laboratory with a kit that generated a PCA3 score (s-PCA3). A prostate biopsy was recommended only in those patients with s-PCA3≥35. Associations between variables were analyzed using the R software.
In patients with a positive s-PCA3 (44.5%), a subsequent biopsy was recommended. Of a total of 151 biopsies studied, 56.3% yielded a diagnosis of PCa. The probability of a positive biopsy increased as the s-PCA3 increased (p=0.041). The percentage of affected cylinders increased as the s-PCA3 increased (p=0.015). A statistically significant relationship was observed between s-PCA3 and both the Gleason score and the Grade Group (p=0.001 and 0.008, respectively). The best log-linear models and a logistic model confirmed the relationships shown previously with Fisher's exact tests.
S-PCA3 may serve as an additional marker to reduce the indication for biopsies and avoid overdiagnosis and overtreatment of patients with suspected PCa. The prognostic significance of s-PCA3 was confirmed, as it was associated with tumor volume and Gleason score. Importantly, to our knowledge this is the first time that an association has been demonstrated between s-PCA3 and the new Grade Group.
Revista espanola de patologia : publicacion oficial de la Sociedad Espanola de Anatomia Patologica y de la Sociedad Espanola de Citologia. 2018 Jun 18 [Epub]
Natalia Rodon, Isabel Trias, Montse Verdú, Miquel Calvo, Josep Mª Banus, Xavier Puig
BIOPAT, Biopatologia Molecular SL, Grup Assistència, Barcelona, Spain. Electronic address: ., BIOPAT, Biopatologia Molecular SL, Grup Assistència, Barcelona, Spain; HISTOPAT Laboratoris, Barcelona, Spain; Hospital de Barcelona, SCIAS, Grup Assistència, Barcelona, Spain., BIOPAT, Biopatologia Molecular SL, Grup Assistència, Barcelona, Spain; HISTOPAT Laboratoris, Barcelona, Spain., Department of Statistics, Faculty of Biology, Universitat de Barcelona, Barcelona, Spain., ICUN, Institut Català d'Urologia i Nefrologia, Barcelona, Spain.