title: Histological chronic prostatitis and high-grade prostate intra-epithelial neoplasia do not influence urinary prostate cancer gene 3 score.
abstract: What's known on the subject? and What does the study add? While the relationship between PCA3 score and clinical or histological prostatitis was quite proven even in small patient groups, conversely the relationship between PCA3 score and HG-PIN is still under debate. We demonstrated in a large series (432 patients) that histologically documented chronic prostatitis and HG-PIN have similar PCA3 scores to patients with BPH and/or normal parenchyma at biopsy.
  
  
  OBJECTIVE
  To determine whether histological chronic prostatitis and high-grade prostate intra-epithelial neoplasia (HG-PIN) influence the prostate cancer gene 3 (PCA3) score in Italian patients with an elevated prostate-specific antigen (PSA) level and a negative digital rectal examination (DRE) who were undergoing a first or repeat prostate biopsy.
  
  
  METHODS
  A urinary PCA3 test was prospectively performed in 432 consecutive patients who were admitted to Gradenigo Hospital (Turin, Italy) between January and December 2011 and scheduled for first or repeat prostate biopsy as a result of an elevated PSA level and negative DRE. A comparison of the PCA3 score and patients with a negative biopsy (normal parenchyma, benign prostatic hyperplasia, chronic prostatitis, HG-PIN) or positive biopsy was performed.
  
  
  RESULTS
  PCA3 median (range) scores varied significantly (P < 0.001) in men with a negative vs positive biopsy: 33 (2-212) and 66 (5-324), respectively. By contrast, men with chronic prostatitis and HG-PIN showed no significant difference with respect to PCA3 score compared to other negative biopsy patients. No correlation was found between the number of positive cores for chronic prostatitis, HG-PIN and PCA3 score. Of all patients with a positive biopsy, 23 (20%) of 114 men had a PCA3 score ≤ 35. In total, 79 (40%) of 197 men with a negative biopsy (normal parenchyma and benign prostatic hyperplasia), 24 (37.5%) of 64 men with chronic prostatitis and 19 (39.6%) of 48 men with HG-PIN had a PCA3 score >35.
  
  
  CONCLUSIONS
  At this early stage of clinical evaluation, cancer specificity of the urinary PCA3 test appears to be maintained in the face of chronic prostatitis and HG-PIN.
authors.affiliation: Division of Urology, Gradenigo Hospital, Italy. delucastefano@yahoo.it
authors.forename: Stefano
authors.initials: S
authors.lastname: De Luca
authors.forename: Roberto
authors.initials: R
authors.lastname: Passera
authors.forename: Angela
authors.initials: A
authors.lastname: Milillo
authors.forename: Renato
authors.initials: R
authors.lastname: Coda
authors.forename: Donato Franco
authors.initials: DF
authors.lastname: Randone
mesh_terms: D000951:Antigens, Neoplasm / Q000652:urine*; D001707:Biopsy, Needle; D002908:Chronic Disease; D006801:Humans; D007558:Italy / Q000453:epidemiology; D008297:Male; D011237:Predictive Value of Tests; D011446:Prospective Studies; D019048:Prostatic Intraepithelial Neoplasia / Q000453:epidemiology / Q000473:pathology / Q000652:urine*; D011471:Prostatic Neoplasms / Q000473:pathology / Q000652:urine*; D011472:Prostatitis / Q000453:epidemiology / Q000473:pathology / Q000652:urine*; D012372:ROC Curve
chemical_list: D000951:Antigens, Neoplasm; C479341:prostate cancer antigen 3, human