title: Value of PCA3 to predict biopsy outcome and its potential role in selecting patients for multiparametric MRI.
abstract: PCA3 (prostate cancer gene 3) and multiparametric 3 tesla MRI are new promising diagnostic tools in the detection of PCa. Our aim was to study the clinical value of the Progensa PCA3-test: its predictive value for biopsy outcome, Gleason score and MRI outcome. We evaluated, retrospectively, 591 patients who underwent a Progensa PCA3-test at the Radboud University Nijmegen Medical Centre between May 2006 and December 2009. Prostate biopsies were performed in 290 patients; a multiparametric 3 tesla MRI of the prostate was performed in 163/591 patients. The PCA3-score was correlated to biopsy results and MRI outcome. The results show that PCA3 was highly predictive for biopsy outcome (p < 0.001); there was no correlation with the Gleason score upon biopsy (p = 0.194). The PCA3-score of patients with a suspicious region for PCa on MRI was significantly higher (p < 0.001) than in patients with no suspicious region on MRI (52 vs. 21). In conclusion, PCA3 is a valuable diagnostic biomarker for PCa; it did not correlate with the Gleason score. Furthermore, multiparametric MRI outcome was significantly correlated with the PCA3-score. Thus, PCA3 could be used to select patients that require MRI. However, in patients with a negative PCA3 and high clinical suspicion of PCa, a multiparametric MRI should also be done.
authors.affiliation: Department of Urology, Radboud University Nijmegen Medical Centre, P.O. Box 9101, 6500 HB Nijmegen, The Netherlands. j.schalken@uro.umcn.nl.
authors.forename: Gisele H J M
authors.initials: GH
authors.lastname: Leyten
authors.forename: Elisabeth A
authors.initials: EA
authors.lastname: Wierenga
authors.forename: J P Michiel
authors.initials: JP
authors.lastname: Sedelaar
authors.forename: Inge M
authors.initials: IM
authors.lastname: van Oort
authors.forename: Jurgen J
authors.initials: JJ
authors.lastname: Futterer
authors.forename: Jelle O
authors.initials: JO
authors.lastname: Barentsz
authors.forename: Jack A
authors.initials: JA
authors.lastname: Schalken
authors.forename: Peter F A
authors.initials: PF
authors.lastname: Mulders
mesh_terms: D000368:Aged; D000951:Antigens, Neoplasm / Q000378:metabolism*; D001706:Biopsy; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D011467:Prostate / Q000473:pathology*; D017430:Prostate-Specific Antigen / Q000378:metabolism; D011471:Prostatic Neoplasms / Q000175:diagnosis* / Q000473:pathology*
chemical_list: D000951:Antigens, Neoplasm; C479341:prostate cancer antigen 3, human; D017430:Prostate-Specific Antigen