Behavior of the PCA3 gene in the urine of men with high grade prostatic intraepithelial neoplasia.
OBJECTIVE
An ideal marker for the early detection of prostate cancer (PCa) should also differentiate between men with isolated high grade prostatic intraepithelial neoplasia (HGPIN) and those with PCa. Prostate Cancer Gene 3 (PCA3) is a highly specific PCa gene and its score, in relation to the PSA gene in post-prostate massage urine (PMU-PCA3), seems to be useful in ruling out PCa, especially after a negative prostate biopsy. Because PCA3 is also expressed in the HGPIN lesion, the aim of this study was to determine the efficacy of PMU-PCA3 scores for ruling out PCa in men with previous HGPIN.


METHODS
The PMU-PCA3 score was assessed by quantitative PCR (multiplex research assay) in 244 men subjected to prostate biopsy: 64 men with an isolated HGPIN (no cancer detected after two or more repeated biopsies), 83 men with PCa and 97 men with benign pathology findings (BP: no PCa, HGPIN or ASAP).


RESULTS
The median PMU-PCA3 score was 1.56 in men with BP, 2.01 in men with HGPIN (p = 0.128) and 9.06 in men with PCa (p = 0.008). The AUC in the ROC analysis was 0.705 in the subset of men with BP and PCa, while it decreased to 0.629 when only men with isolated HGPIN and PCa were included in the analysis. Fixing the sensitivity of the PMU-PCA3 score at 90%, its specificity was 79% in men with BP and 69% in men with isolated HGPIN.


CONCLUSIONS
The efficacy of the PMU-PCA3 score to rule out PCa in men with HGPIN is lower than in men with BP.
Morote
Juan
J
Department of Urology, Vall d'Hebron University Hospital, Pg. Vall d'Hebron 119-129, 08035, Barcelona, Spain. jmorote@vhebron.net
Rigau
Marina
M
Garcia
Marta
M
Mir
Carmen
C
Ballesteros
Carlos
C
Planas
Jacques
J
Raventós
Carles X
CX
Placer
José
J
de Torres
Inés M
IM
Reventós
Jaume
J
Doll
Andreas
A
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000951:Antigens, Neoplasm / Q000652:urine*; D014408:Biomarkers, Tumor / Q000652:urine*; D001706:Biopsy; D016022:Case-Control Studies; D003937:Diagnosis, Differential; D006801:Humans; D008297:Male; D008875:Middle Aged; D019048:Prostatic Intraepithelial Neoplasia / Q000175:diagnosis* / Q000473:pathology / Q000652:urine*; D011471:Prostatic Neoplasms / Q000175:diagnosis* / Q000473:pathology / Q000652:urine*; D012680:Sensitivity and Specificity
D000951:Antigens, Neoplasm; D014408:Biomarkers, Tumor; C479341:prostate cancer antigen 3, human