title: Prostate cancer antigen 3 test for prostate biopsy decision: a systematic review and meta analysis.
abstract: BACKGROUND
  The specificity for early interventions of prostate-specific antigen (PSA) in prostate cancer (PCa) is not satisfactory. It is likely that prostate cancer antigen 3 (PCA3) can be used to predict biopsy outcomes more accurately than PSA for the early detection of PCa. We systematically reviewed literatures and subsequently performed a meta-analysis.
  
  
  METHODS
  A bibliographic search in the database of Embase, Medline, Web of Science, NCBI, PubMed, CNKI, and those of health technology assessment agencies published before April 2013 was conducted. The key words used were "prostatic neoplasms", "prostate", "'prostate', 'carcinoma' or 'cancer' or 'tumor', or 'PCa,'" and free terms of "upm3", "pca3", "dd3", "aptimapca 3", and "prostate cancer antigen 3". All patients were adults. The intervention was detecting PCA3 in urine samples for PCa diagnosis. We checked the quality based on the QUADAS criteria, collected data, and developed a meta-analysis to synthesize results. Twenty-four studies of diagnostic tests with moderate to high quality were selected.
  
  
  RESULTS
  The sensitivity was between 46.9% and 82.3%; specificity was from 55% to 92%; positive predictive value had a range of 39.0%-86.0%; and the negative predictive value was 61.0%-89.7%. The meta-analysis has heterogeneity between studies. The global sensitivity value was 0.82 (95% CI 0.72-0.90); specificity was 0.962 (95% CI 0.73-0.99); positive likelihood ratio was 2.39 (95% CI 2.10-2.71); negative likelihood ratio was 0.51 (95% CI 0.46-0.86); diagnostic odds ratio was 4.89 (95% CI 3.94-6.06); and AUC in SROC curve was 0.744 1.
  
  
  CONCLUSIONS
  PCA3 can be used for early diagnosis of PCa and to avoid unnecessary biopsies.
authors.affiliation: Department of Urology, the First Affiliated Hospital of Chongqing Medical University, Chongqing 400016, China.
authors.forename: Yong
authors.initials: Y
authors.lastname: Luo
authors.affiliation: Department of Urology, the First Affiliated Hospital of Chongqing Medical University, Chongqing 400016, China? Email: gouxincq@163.com.
authors.forename: Xin
authors.initials: X
authors.lastname: Gou
authors.affiliation: Department of Urology, the First Affiliated Hospital of Chongqing Medical University, Chongqing 400016, China.
authors.forename: Peng
authors.initials: P
authors.lastname: Huang
authors.affiliation: Department of Urology, the First Affiliated Hospital of Chongqing Medical University, Chongqing 400016, China.
authors.forename: Chan
authors.initials: C
authors.lastname: Mou
mesh_terms: D000951:Antigens, Neoplasm / Q000378:metabolism*; D014408:Biomarkers, Tumor / Q000378:metabolism*; D001706:Biopsy; D006801:Humans; D008297:Male; D011471:Prostatic Neoplasms / Q000175:diagnosis* / Q000378:metabolism*
chemical_list: D000951:Antigens, Neoplasm; D014408:Biomarkers, Tumor; C479341:prostate cancer antigen 3, human