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BMC Urology

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Open Access 01-12-2015 | Research article

Clinical evaluation of prostate cancer gene 3 score in diagnosis among Chinese men with prostate cancer and benign prostatic hyperplasia

Authors: Jin Huang, Kathleen H. Reilly, Hui-Zhen Zhang, Hai-Bo Wang

Published in: BMC Urology | Issue 1/2015

Abstract

Background

Prostate cancer is the second most common diagnosed cancer in men. Due to the low specificity of current diagnosis methods for detecting prostate cancer, identification of new biomarkers is highly desirable. The study was conducted to determine the clinical utility of the prostate cancer gene 3 (PCA3) assay to predict biopsy-detected cancers in Chinese men.

Methods

The study included men who had a biopsy at The Affiliated Sixth People’s Hospital of Shanghai Jiao Tong University from January 2013 to December 2013. Formalin-fixed, paraffin-embedded tissue blocks were used to test PCA3 and prostate-specific antigen (PSA) mRNA. The diagnostic accuracy of the PCA3 score for predicting a positive biopsy outcome was studied using sensitivity and specificity, and it was compared with PSA.

Results

The probability of a positive biopsy increased with increasing PCA3 scores. The mean PCA3 score was significantly higher in men with prostate cancer (198.03, 95 % confidence interval [CI] 74.79–321.27) vs benign prostatic hyperplasia (BPH) (84.31, 95 % CI 6.47–162.15, P < 0.01). The PCA3 score (cutoff 35) had a sensitivity of 85.7 % and specificity of 62.5 %. Receiver operating characteristic analysis showed higher areas under the ROC curve for the PCA3 score vs PSA, but without statistical significance.

Conclusions

Increased PCA3 in biopsy tissue correlated with prostate cancer and the PCA3 assay may improve the diagnosis efficacy as the PCA3 score being independent of PSA level. The diagnostic significance of urinary PCA3 testing should be explored in future study to determine the prediction value in guiding biopsy decision as the clinical relevance of current study was limited for PCA3 testing based on biopsy tissue in a limited number of Chinese men.

Torre LA, Bray F, Siegel RL, Ferlay J, Lortet-Tieulent J, Jemal A. Global cancer statistics, 2012. CA Cancer J Clin. 2015. doi:10.3322/caac.21262.

Catalona WJ, Hudson MA, Scardino PT, Richie JP, Ahmann FR, Flanigan RC, et al. Selection of optimal prostate specific antigen cutoffs for early detection of prostate cancer: receiver operating characteristic curves. J Urol. 1994;152(6 Pt 1):2037–42.PubMed

Nadji M, Tabei SZ, Castro A, Chu TM, Murphy GP, Wang MC, et al. Prostatic-specific antigen: an immunohistologic marker for prostatic neoplasms. Cancer. 1981;48(5):1229–32.CrossRefPubMed

Pelzer AE, Horninger W. How should PSA screening efforts be focused to prevent underdiagnosis and overdiagnosis of prostate cancer? Nat Clin Pract Urol. 2008;5(4):172–3. doi:10.1038/ncpuro1051.PubMed

Nath A, Singh JK, Vendan SE, Priyanka, Sinha S. Elevated level of prostate specific antigen among prostate cancer patients and high prevalence in the Gangetic zone of Bihar, India. Asian Pac J Cancer Prev. 2012;13(1):221–3.CrossRefPubMed

Thompson IM, Pauler DK, Goodman PJ, Tangen CM, Lucia MS, Parnes HL, et al. Prevalence of prostate cancer among men with a prostate-specific antigen level < or =4.0 ng per milliliter. N Engl J Med. 2004;350(22):2239–46. doi:10.1056/NEJMoa031918.CrossRefPubMed

Raja J, Ramachandran N, Munneke G, Patel U. Current status of transrectal ultrasound-guided prostate biopsy in the diagnosis of prostate cancer. Clin Radiol. 2006;61(2):142–53. doi:10.1016/j.crad.2005.10.002.CrossRefPubMed

Ozden E, Bostanci Y, Yakupoglu KY, Akdeniz E, Yilmaz AF, Tulek N, et al. Incidence of acute prostatitis caused by extended-spectrum beta-lactamase-producing Escherichia coli after transrectal prostate biopsy. Urology. 2009;74(1):119–23. doi:10.1016/j.urology.2008.12.067.CrossRefPubMed

Raaijmakers R, Kirkels WJ, Roobol MJ, Wildhagen MF, Schrder FH. Complication rates and risk factors of 5802 transrectal ultrasound-guided sextant biopsies of the prostate within a population-based screening program. Urology. 2002;60(5):826–30.CrossRefPubMed

10.

Haese A, de la Taille A, van Poppel H, Marberger M, Stenzl A, Mulders PF, et al. Clinical utility of the PCA3 urine assay in European men scheduled for repeat biopsy. Eur Urol. 2008;54(5):1081–8. doi:10.1016/j.eururo.2008.06.071.CrossRefPubMed

11.

Deras IL, Aubin SM, Blase A, Day JR, Koo S, Partin AW, et al. PCA3: a molecular urine assay for predicting prostate biopsy outcome. J Urol. 2008;179(4):1587–92. doi:10.1016/j.juro.2007.11.038.CrossRefPubMed

12.

Chun FK, de la Taille A, van Poppel H, Marberger M, Stenzl A, Mulders PF, et al. Prostate cancer gene 3 (PCA3): development and internal validation of a novel biopsy nomogram. Eur Urol. 2009;56(4):659–67. doi:10.1016/j.eururo.2009.03.029.CrossRefPubMed

13.

Hessels D, Schalken JA. The use of PCA3 in the diagnosis of prostate cancer. Nat Rev Urol. 2009;6(5):255–61. doi:10.1038/nrurol.2009.40.CrossRefPubMed

14.

Klatte T, Waldert M, de Martino M, Schatzl G, Mannhalter C, Remzi M. Age-specific PCA3 score reference values for diagnosis of prostate cancer. World J Urol. 2012;30(3):405–10. doi:10.1007/s00345-011-0749-1.CrossRefPubMed

15.

Salami SS, Schmidt F, Laxman B, Regan MM, Rickman DS, Scherr D, et al. Combining urinary detection of TMPRSS2:ERG and PCA3 with serum PSA to predict diagnosis of prostate cancer. Urol Oncol. 2013;31(5):566–71. doi:10.1016/j.urolonc.2011.04.001.PubMedCentralCrossRefPubMed

16.

de Kok JB, Verhaegh GW, Roelofs RW, Hessels D, Kiemeney LA, Aalders TW, et al. DD3(PCA3), a very sensitive and specific marker to detect prostate tumors. Cancer Res. 2002;62(9):2695–8.PubMed

17.

Aubin SM, Reid J, Sarno MJ, Blase A, Aussie J, Rittenhouse H, et al. Prostate cancer gene 3 score predicts prostate biopsy outcome in men receiving dutasteride for prevention of prostate cancer: results from the REDUCE trial. Urology. 2011;78(2):380–5. doi:10.1016/j.urology.2011.03.033.CrossRefPubMed

18.

Nakanishi H, Groskopf J, Fritsche HA, Bhadkamkar V, Blase A, Kumar SV, et al. PCA3 molecular urine assay correlates with prostate cancer tumor volume: implication in selecting candidates for active surveillance. J Urol. 2008;179(5):1804–9. doi:10.1016/j.juro.2008.01.013. discussion 9–10.CrossRefPubMed

19.

Ploussard G, Haese A, Van Poppel H, Marberger M, Stenzl A, Mulders PF, et al. The prostate cancer gene 3 (PCA3) urine test in men with previous negative biopsies: does free-to-total prostate-specific antigen ratio influence the performance of the PCA3 score in predicting positive biopsies? BJU Int. 2010;106(8):1143–7. doi:10.1111/j.1464-410X.2010.09286.x.CrossRefPubMed

20.

Shen M, Chen W, Yu K, Chen Z, Zhou W, Lin X, et al. The diagnostic value of PCA3 gene-based analysis of urine sediments after digital rectal examination for prostate cancer in a Chinese population. Exp Mol Pathol. 2011;90(1):97–100. doi:10.1016/j.yexmp.2010.10.009.CrossRefPubMed

21.

DeLong ER, DeLong DM, Clarke-Pearson DL. Comparing the areas under two or more correlated receiver operating characteristic curves: a nonparametric approach. Biometrics. 1988;44(3):837–45.CrossRefPubMed

22.

de la Taille A, Irani J, Graefen M, Chun F, de Reijke T, Kil P, et al. Clinical evaluation of the PCA3 assay in guiding initial biopsy decisions. J Urol. 2011;185(6):2119–25. doi:10.1016/j.juro.2011.01.075.CrossRefPubMed

23.

Kattan MW. Evaluating a new marker’s predictive contribution. Clin Cancer Res. 2004;10(3):822–4.CrossRefPubMed

24.

De Luca S, Passera R, Bollito E, Milillo A, Scarpa RM, Papotti M, et al. Biopsy and radical prostatectomy pathological patterns influence Prostate cancer gene 3 (PCA3) score. Anticancer Res. 2013;33(10):4657–62.PubMed

Title: Clinical evaluation of prostate cancer gene 3 score in diagnosis among Chinese men with prostate cancer and benign prostatic hyperplasia
Authors: Jin Huang
Kathleen H. Reilly
Hui-Zhen Zhang
Hai-Bo Wang
Publication date: 01-12-2015
Publisher: BioMed Central
Published in: BMC Urology / Issue 1/2015
Electronic ISSN: 1471-2490
DOI: https://doi.org/10.1186/s12894-015-0110-x

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Clinical evaluation of prostate cancer gene 3 score in diagnosis among Chinese men with prostate cancer and benign prostatic hyperplasia

Abstract

Background

Methods

Results

Conclusions

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Abstract

Background

Methods

Results

Conclusions

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