title: Predicting prostate biopsy outcome: prostate health index (phi) and prostate cancer antigen 3 (PCA3) are useful biomarkers.
abstract: Indication for prostate biopsy is presently mainly based on prostate-specific antigen (PSA) serum levels and digital-rectal examination (DRE). In view of the unsatisfactory accuracy of these two diagnostic exams, research has focused on novel markers to improve pre-biopsy prostate cancer detection, such as phi and PCA3. The purpose of this prospective study was to assess the diagnostic accuracy of phi and PCA3 for prostate cancer using biopsy as gold standard. Phi index (Beckman coulter immunoassay), PCA3 score (Progensa PCA3 assay) and other established biomarkers (tPSA, fPSA and %fPSA) were assessed before a 18-core prostate biopsy in a group of 251 subjects at their first biopsy. Values of %p2PSA and phi were significantly higher in patients with PCa compared with PCa-negative group (p<0.001) and also compared with high grade prostatic intraepithelial neoplasia (HGPIN) (p<0.001). PCA3 score values were significantly higher in PCa compared with PCa-negative subjects (p<0.001) and in HGPIN vs PCa-negative patients (p<0.001). ROC curve analysis showed that %p2PSA, phi and PCA3 are predictive of malignancy. In conclusion, %p2PSA, phi and PCA3 may predict a diagnosis of PCa in men undergoing their first prostate biopsy. PCA3 score is more useful in discriminating between HGPIN and non-cancer.
authors.affiliation: Department of Urology, University of Naples Federico II, Naples, Italy.
authors.forename: Matteo
authors.initials: M
authors.lastname: Ferro
authors.forename: Dario
authors.initials: D
authors.lastname: Bruzzese
authors.forename: Sisto
authors.initials: S
authors.lastname: Perdonà
authors.forename: Claudia
authors.initials: C
authors.lastname: Mazzarella
authors.forename: Ada
authors.initials: A
authors.lastname: Marino
authors.forename: Alessandra
authors.initials: A
authors.lastname: Sorrentino
authors.forename: Angelina
authors.initials: A
authors.lastname: Di Carlo
authors.forename: Riccardo
authors.initials: R
authors.lastname: Autorino
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Di Lorenzo
authors.forename: Carlo
authors.initials: C
authors.lastname: Buonerba
authors.forename: Vincenzo
authors.initials: V
authors.lastname: Altieri
authors.forename: Angela
authors.initials: A
authors.lastname: Mariano
authors.forename: Vincenzo
authors.initials: V
authors.lastname: Macchia
authors.forename: Daniela
authors.initials: D
authors.lastname: Terracciano
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000951:Antigens, Neoplasm / Q000097:blood*; D014408:Biomarkers, Tumor / Q000097:blood*; D001706:Biopsy; D051517:Digital Rectal Examination; D006801:Humans; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D011237:Predictive Value of Tests; D011446:Prospective Studies; D011467:Prostate / Q000473:pathology*; D017430:Prostate-Specific Antigen / Q000097:blood*; D011471:Prostatic Neoplasms / Q000097:blood / Q000175:diagnosis* / Q000473:pathology
chemical_list: D000951:Antigens, Neoplasm; D014408:Biomarkers, Tumor; C479341:prostate cancer antigen 3, human; D017430:Prostate-Specific Antigen