title: Pathological patterns of prostate biopsy in men with fluctuations of prostate cancer gene 3 score: a preliminary report.
abstract: BACKGROUND
  To evaluate pathological patterns of prostate biopsy in men with changes in risk class by prostate cancer gene 3 (PCA3) score and with elevated serum prostate-specific antigen (PSA) or positive digital rectal examination (DRE), undergoing a repeat biopsy.
  
  
  METHODS
  A total of 108 males of two Italian Institutions who had undergone at least two PCA3 score assessments with changed PCA3 risk class were selected. Comparison of PCA3 score in patients with negative re-biopsy [normal parenchyma, benign prostatic hyperplasia (BPH), chronic prostatitis, high-grade prostate intraepithelial neoplasia (HG-PIN), atypical small acinar prostate (ASAP)] or positive re-biopsy was performed.
  
  
  RESULTS
  The up- and down-grading rates for PCA3 score were 71.3% (n=77) and 28.7% (n=31), respectively. Among the 77 up-graded patients, the median change in PCA3 score was 24 (range=4-69), while among the 31 down-graded ones, the median change was 17 (2 to 55). The PCA3 score in 24 out of 29 (82.7%) patients with prostate cancer (PCa) was up-graded. No association was found for correlation of PCA3 score change with age >65 years (p=0.975), family history of prostate cancer (p=0.796), positive DRE (p=0.179), use of 5-alpha-reductase inhibitors (p=0.793) and BPH/prostatitis/HG-PIN/ASAP diagnosis (p=0.428).
  
  
  CONCLUSIONS
  PCA3 score can be considered a marker that is stable over time in most cases; notably, up to 20% of patients have a clinically relevant change of risk class. The rate of PCa was higher in patients whose PCA3 score was up-graded, even if no robust cut-off for PCA3 score fluctuation was identified.
authors: Urology, San Luigi Gonzaga Hospital and University of Torino, Orbassano, Italy.
authors: Stefano
authors: S
authors: De Luca
authors: Nuclear Medicine, San Giovanni Battista Hospital and University of Torino, Torino, Italy rpassera@cittadellasalute.to.it.
authors: Roberto
authors: R
authors: Passera
authors: Pathology, San Luigi Gonzaga Hospital and University of Torino, Orbassano, Italy.
authors: Susanna
authors: S
authors: Cappia
authors: Pathology, San Luigi Gonzaga Hospital and University of Torino, Orbassano, Italy.
authors: Enrico
authors: E
authors: Bollito
authors: Urology, Gradenigo Hospital, Torino, Italy.
authors: Donato Franco
authors: DF
authors: Randone
authors: Urology, San Luigi Gonzaga Hospital and University of Torino, Orbassano, Italy.
authors: Francesco
authors: F
authors: Porpiglia
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000951:Antigens, Neoplasm / Q000235:genetics* / Q000378:metabolism; D001706:Biopsy; D006801:Humans; D008297:Male; D008875:Middle Aged; D011467:Prostate / Q000473:pathology; D017430:Prostate-Specific Antigen / Q000097:blood; D011470:Prostatic Hyperplasia / Q000235:genetics* / Q000378:metabolism; D019048:Prostatic Intraepithelial Neoplasia / Q000235:genetics* / Q000473:pathology; D011471:Prostatic Neoplasms / Q000235:genetics* / Q000473:pathology; D011472:Prostatitis / Q000235:genetics* / Q000473:pathology; D012307:Risk Factors
chemical_list: D000951:Antigens, Neoplasm; C479341:prostate cancer antigen 3, human; D017430:Prostate-Specific Antigen
keywords: high-grade prostate intraepithelial neoplasia; prostate cancer; prostate cancer gene 3; prostate-specific antigen; prostatitis