INTRODUCTION AND OBJECTIVE: PCA3 is a urinary marker that has shown promise in predicting for presence of prostate cancer (PCa) in men undergoing repeat prostate biopsy (PBx).
We aim to study PCA3 prior to initial PBx.
METHODS: Records from a single organization were retrospectively reviewed. The predictive value of PCA3 was explored using non-parametric receiver operating characteristic curve analysis (ROC) and multivariable logistic regression analysis.
RESULTS: 3073 men underwent PCA3 analysis prior to initial PBx sampling 12-14 areas. Mean PCA3 was 27.2 and 52.5 for patients without and with cancer respectively. PCa was identified in 1341 (43.6%) men. 54.5% had Gleason 6. 45.5% had Gleason ≥ 7 (HGPCa). Mean PCA3 was 47.5 and 58.5 for the patients with Gleason 6 and ≥ 7, respectively. On multivariable logistic analysis, PCA3 was statistically significantly associated with PCa and HGPCa after adjusting for PSA (p < 0.001 for both), free PSA (p=0.04 and p=0.01 respectively), age (p< 0.001 for both), FH (p < 0.001 and P=0.59 respectively), abnormal DRE (p=0.31 and p < 0.001 respectively), PV (p< 0.001 for both) and BMI (p< 0.001 for both). Using ROC analysis, PCA3 outperformed PSA in prediction of PCa (AUC=0.697 vs. 0.599, p < 0.01), but not for HGPCa (AUC=0.682 vs. 0.679, p=0.702).
CONCLUSIONS: PCA3 proved a useful tool in identifying patients at risk for PCa prior to initial PBx. To our knowledge this is the largest PCA3 study initial biopsy population. These results suggest further exploration of the value of PCA3 is warranted.
Written by:
Chevli KK, Duff M, Walter P, Yu C, Capuder B, Elshafei A, Malczewski S, Kattan MW, Jones JS. Are you the author?
Department of Urology, University at Buffalo School of Medicine and Biomedical Sciences, Buffalo, NY, USA; Western New York Urology Associates, LLC, Cheektowaga, NY USA; Department of Urology, University at Buffalo School of Medicine and Biomedical Sciences, Buffalo, NY, USA; Western New York Urology Associates, LLC, Cheektowaga, NY USA; Department of Quantitative Health Sciences, Cleveland Clinic, Cleveland, OH, USA; Department of Urology, Cleveland Clinic, Cleveland, OH, USA.
Reference: J Urol. 2013 Dec 10. pii: S0022-5347(13)06087-4.
doi: 10.1016/j.juro.2013.12.005
PubMed Abstract
PMID: 24333241
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