title: PCA3 score vs PSA free/total accuracy in prostate cancer diagnosis at repeat saturation biopsy.
abstract: OBJECTIVE
  PCA3 score and PSA free/total (F/T) accuracy in PCa diagnosis at repeat saturation prostate biopsy (SPBx) in patients with PSA between 4 and 10 ng/mL was evaluated.
  
  
  METHODS
  From October 2009 to September 2011 74 men (median 64 years) with persistent high or increasing PSA values, negative DRE, median PSA values of 8.9 ng/mL and primary negative extended biopsy underwent a SPBx (median 28 cores) for persistent suspicion for PCa.
  
  
  RESULTS
  PCA3 >20 and >35, PSA F/T ≤15%, ≤20% and ≤25% identified 25, 21, 18, 23 and 26 out 27 cancer, respectively. PCA3 cut-off of 20 demonstrated the best accuracy with an AUC-ROC curve of 0.73.
  
  
  CONCLUSIONS
  The NPV equal to 88.9% suggests to use PCA3 cut-off 20 as an exclusion tool; moreover, PCA3 cut-off of 35 combined with PSA F/T ≤15% allows to spare 32.4% of unnecessary repeat biopsies.
authors.affiliation: Urology Unit, Cannizzaro Hospital, Via Messina 829, Catania, Italy. piepepe@hotmail.com
authors.forename: Pietro
authors.initials: P
authors.lastname: Pepe
authors.forename: Francesco
authors.initials: F
authors.lastname: Aragona
mesh_terms: D000368:Aged; D000951:Antigens, Neoplasm / Q000096:biosynthesis*; D019540:Area Under Curve; D001706:Biopsy / Q000379:methods*; D006801:Humans; D008297:Male; D008495:Medical Oncology / Q000379:methods; D008875:Middle Aged; D011467:Prostate / Q000473:pathology; D017430:Prostate-Specific Antigen / Q000096:biosynthesis; D011471:Prostatic Neoplasms / Q000097:blood* / Q000175:diagnosis*; D012372:ROC Curve; D015203:Reproducibility of Results
chemical_list: D000951:Antigens, Neoplasm; C479341:prostate cancer antigen 3, human; D017430:Prostate-Specific Antigen