title: PCA3 score before radical prostatectomy predicts extracapsular extension and tumor volume.
abstract: OBJECTIVE
  PCA3 is a prostate specific, nonprotein coding RNA that is over expressed in prostate cancer. Recent studies showed the diagnostic potential of a urine based PCA3 for predicting biopsy outcome. We assessed the relationship between urine PCA3 and pathological features in whole mount radical prostatectomy specimens.
  
  
  METHODS
  Post-digital rectal examination urine specimens were obtained from 72 men with prostate cancer before radical prostatectomy. PCA3 and PSA mRNA were measured. The ratio of PCA3 to PSA mRNA was recorded as a PCA3 score and correlated with data on each prostate specimen.
  
  
  RESULTS
  Patients with extracapsular extension had a significantly higher median PCA3 score than patients without extracapsular extension (48.8 vs 18.7, p = 0.02). PCA3 score significantly correlated with total tumor volume (r = 0.38, p <0.01). On multivariate analysis PCA3 score was an independent predictor of extracapsular extension (p = 0.01) and total tumor volume less than 0.5 cc (p = 0.04). At a cutoff PCA3 score of 47 extracapsular extension was predicted with 94% specificity and an 80% positive predictive value. When combined with serum PSA and biopsy Gleason score, the ROC AUC for predicting extracapsular extension was 0.90.
  
  
  CONCLUSIONS
  PCA3 detected in the post-digital rectal examination urine of patients with prostate cancer correlated with pathological findings. Therefore, it could provide prognostic information. To our knowledge this is the first report of a molecular urine assay that predicts extracapsular extension.
authors.affiliation: Urology Service, Walter Reed Army Medical Center, Washington, DC 20307, USA.
authors.forename: Eric J
authors.initials: EJ
authors.lastname: Whitman
authors.forename: Jack
authors.initials: J
authors.lastname: Groskopf
authors.forename: Amina
authors.initials: A
authors.lastname: Ali
authors.forename: Yongmei
authors.initials: Y
authors.lastname: Chen
authors.forename: Amy
authors.initials: A
authors.lastname: Blase
authors.forename: Bungo
authors.initials: B
authors.lastname: Furusato
authors.forename: Gyorgy
authors.initials: G
authors.lastname: Petrovics
authors.forename: Mona
authors.initials: M
authors.lastname: Ibrahim
authors.forename: Sally
authors.initials: S
authors.lastname: Elsamanoudi
authors.forename: Jennifer
authors.initials: J
authors.lastname: Cullen
authors.forename: Isabell A
authors.initials: IA
authors.lastname: Sesterhenn
authors.forename: Stephen
authors.initials: S
authors.lastname: Brassell
authors.forename: Harry
authors.initials: H
authors.lastname: Rittenhouse
authors.forename: Shiv
authors.initials: S
authors.lastname: Srivastava
authors.forename: David G
authors.initials: DG
authors.lastname: McLeod
mesh_terms: D000328:Adult; D000368:Aged; D000704:Analysis of Variance; D000951:Antigens, Neoplasm / Q000235:genetics / Q000378:metabolism*; D014408:Biomarkers, Tumor / Q000652:urine; D001707:Biopsy, Needle; D015331:Cohort Studies; D051517:Digital Rectal Examination; D006801:Humans; D007150:Immunohistochemistry; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009361:Neoplasm Invasiveness / Q000473:pathology*; D009367:Neoplasm Staging; D011237:Predictive Value of Tests; D011300:Preoperative Care / Q000379:methods; D011336:Probability; D011379:Prognosis; D017430:Prostate-Specific Antigen / Q000097:blood*; D011468:Prostatectomy / Q000379:methods; D011471:Prostatic Neoplasms / Q000401:mortality / Q000473:pathology* / Q000601:surgery*; D012333:RNA, Messenger / Q000032:analysis; D012372:ROC Curve; D018570:Risk Assessment; D015996:Survival Rate; D016896:Treatment Outcome; D047368:Tumor Burden
chemical_list: D000951:Antigens, Neoplasm; D014408:Biomarkers, Tumor; D012333:RNA, Messenger; C479341:prostate cancer antigen 3, human; D017430:Prostate-Specific Antigen