title: PSCA mRNA expression in preoperatively negative prostate biopsies predicts incidental prostate cancer in patients undergoing transurethral resection of the prostate for benign prostatic hyperplasia.
abstract: BACKGROUND
  Recent data showed that prostate stem cell antigen (PSCA) mRNA expression is predictive of the subsequent cancer in BPH patients treated with TURP. This study was to determine whether PSCA mRNA expression in preoperatively negative biopsies identified the presence of incidental prostate cancer (IPCa) on TURP tissues analysis.
  
  
  METHODS
  PSCA in situ hybridization was performed in preoperatively negative prostatic biopsies taken from 592 enrolled BPH patients. Predictive performance of PSCA mRNA for IPCa was evaluated by the Cox proportional hazards models.
  
  
  RESULTS
  PSCA mRNA positivity in negative biopsy specimens was detected in 84 (14.2%) of 592 men. Of those 84 patients, 57 were histopathologically identified as having PCa on their TURP tissues. None of the rest 508 men with negative PSCA mRNA expression were diagnosed with IPCa. Spearman's rank correlation coefficient showed that PSCA mRNA expression levels were correlated significantly and positively with Gleason score (r = 0.80, P < 0.001) and clinical stage (r = 0.86, P < 0.001). A multivariate Cox model demonstrated that only PSCA mRNA positivity was predictive of the IPCa presence on TURP (HR = 4.04; 95% CI: 2.12-5.42; P < 0.001), with the concordance index of 0.878.
  
  
  CONCLUSIONS
  PSCA mRNA positivity in negative biopsies is a promising marker for the presence of IPCa in BPH patients.
authors.affiliation: Department of Urology, Minimally Invasive Surgery Center, The First Affiliated Hospital, Guangzhou Medical College, Guangzhou, Guangdong Province, China. zgzhaodr@yahoo.com.cn
authors.forename: Zhigang
authors.initials: Z
authors.lastname: Zhao
authors.forename: Wenjing
authors.initials: W
authors.lastname: Ma
authors.forename: Guohua
authors.initials: G
authors.lastname: Zeng
authors.forename: Defeng
authors.initials: D
authors.lastname: Qi
mesh_terms: D000230:Adenocarcinoma / Q000235:genetics* / Q000473:pathology / Q000601:surgery; D000368:Aged; D000369:Aged, 80 and over; D000951:Antigens, Neoplasm / Q000235:genetics*; D001706:Biopsy; D015331:Cohort Studies; D018450:Disease Progression; D058851:GPI-Linked Proteins / Q000235:genetics; D006801:Humans; D017403:In Situ Hybridization; D015994:Incidence; D008297:Male; D008875:Middle Aged; D009363:Neoplasm Proteins / Q000235:genetics*; D011237:Predictive Value of Tests; D011300:Preoperative Care; D017430:Prostate-Specific Antigen / Q000097:blood; D011470:Prostatic Hyperplasia / Q000235:genetics* / Q000473:pathology / Q000601:surgery; D011471:Prostatic Neoplasms / Q000235:genetics* / Q000473:pathology / Q000601:surgery; D012333:RNA, Messenger / Q000235:genetics*; D015996:Survival Rate; D020728:Transurethral Resection of Prostate
chemical_list: D000951:Antigens, Neoplasm; D058851:GPI-Linked Proteins; D009363:Neoplasm Proteins; C110843:PSCA protein, human; D012333:RNA, Messenger; D017430:Prostate-Specific Antigen