title: Use of PCA3 in detecting prostate cancer in initial and repeat prostate biopsy patients.
abstract: BACKGROUND
  The PCA3 urinary assay has shown promise in predicting the presence of prostate cancer. We evaluated the value of this test in patients undergoing initial and repeat prostate biopsy.
  
  
  METHODS
  PCA3 and PSA levels were obtained from 456 men with no known personal history of prostate cancer prior to prostate biopsy. Two hundred eighty-nine men underwent an initial prostate biopsy and 167 underwent a repeat prostate biopsy. PCA3 and PSA levels were compared to the prostate biopsy results.
  
  
  RESULTS
  PCA3 score was shown to be independent of prostate volume (P = 0.162) and PSA level (P = 0.959). PCA3 scores were significantly higher in patients with cancer on prostate biopsy compared to patients with negative biopsy results (P < 0.0001). In logistic regression, PCA3 showed a significantly higher AUC than PSA (0.726 vs. 0.512, P = 0.0001). This difference persisted when examining the initial biopsy subgroup, with PCA3 out-performing PSA (AUC 0.772 vs. AUC = 0.552, P < 0.0001), but not in the repeat biopsy subgroup (AUC = 0.605 vs. AUC = 0.500, P = 0.2488).
  
  
  CONCLUSIONS
  PCA3 was found to be a better predictor of prostate cancer than PSA in the total population as well as the initial biopsy population, but was not superior to PSA in the repeat biopsy population. Prostate 73: 48-53, 2013. © 2012 Wiley Periodicals, Inc.
authors.affiliation: Department of Urology, University at Buffalo, Buffalo, NY, USA. rrgoode@buffalo.edu
authors.forename: Roland R
authors.initials: RR
authors.lastname: Goode
authors.forename: Susan J
authors.initials: SJ
authors.lastname: Marshall
authors.forename: Michael
authors.initials: M
authors.lastname: Duff
authors.forename: Eric
authors.initials: E
authors.lastname: Chevli
authors.forename: K Kent
authors.initials: KK
authors.lastname: Chevli
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000951:Antigens, Neoplasm / Q000097:blood*; D019540:Area Under Curve; D014408:Biomarkers, Tumor / Q000378:metabolism; D001706:Biopsy; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D011237:Predictive Value of Tests; D011467:Prostate / Q000378:metabolism / Q000473:pathology*; D017430:Prostate-Specific Antigen / Q000097:blood*; D019048:Prostatic Intraepithelial Neoplasia / Q000097:blood / Q000175:diagnosis*; D011471:Prostatic Neoplasms / Q000097:blood / Q000175:diagnosis*; D015203:Reproducibility of Results; D012189:Retrospective Studies; D012720:Severity of Illness Index
chemical_list: D000951:Antigens, Neoplasm; D014408:Biomarkers, Tumor; C479341:prostate cancer antigen 3, human; D017430:Prostate-Specific Antigen