PCA3 score vs PSA free/total accuracy in prostate cancer diagnosis at repeat saturation biopsy - Abstract

AIM: PCA3 score and PSA free/total (F/T) accuracy in PCa diagnosis at repeat saturation prostate biopsy (SPBx) in patients with PSA between 4 and 10 ng/mL was evaluated.

MATERIALS AND METHODS: From October 2009 to September 2011 74 men (median 64 years) with persistent high or increasing PSA values, negative DRE, median PSA values of 8.9 ng/mL and primary negative extended biopsy underwent a SPBx (median 28 cores) for persistent suspicion for PCa.

RESULTS: PCA3 >20 and >35, PSA F/T ≤ 15%, ≤ 20% and ≤ 25% identified 25, 21, 18, 23 and 26 out 27 cancer, respectively. PCA3 cut-off of 20 demonstrated the best accuracy with an AUC-ROC curve of 0.73.

CONCLUSION: The NPV equal to 88.9% suggests to use PCA3 cut-off 20 as an exclusion tool; moreover, PCA3 cut-off of 35 combined with PSA F/T ≤ 15% allows to spare 32.4% of unnecessary repeat biopsies.

Written by:
Pepe P, Aragona F.   Are you the author?
Urology Unit, Cannizzaro Hospital, Via Messina 829, Catania, Italy.

Reference: Anticancer Res. 2011 Dec;31(12):4445-9.

PubMed Abstract
PMID: 22199313

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