PCA3 score before radical prostatectomy predicts extracapsular extension and tumor volume.
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.
Whitman
Eric J
EJ
Urology Service, Walter Reed Army Medical Center, Washington, DC 20307, USA.
Groskopf
Jack
J
Ali
Amina
A
Chen
Yongmei
Y
Blase
Amy
A
Furusato
Bungo
B
Petrovics
Gyorgy
G
Ibrahim
Mona
M
Elsamanoudi
Sally
S
Cullen
Jennifer
J
Sesterhenn
Isabell A
IA
Brassell
Stephen
S
Rittenhouse
Harry
H
Srivastava
Shiv
S
McLeod
David G
DG
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
D000951:Antigens, Neoplasm; D014408:Biomarkers, Tumor; D012333:RNA, Messenger; C479341:prostate cancer antigen 3, human; D017430:Prostate-Specific Antigen