Diagnosis accuracy of PCA3 level in patients with prostate cancer: a systematic review with meta-analysis

Abstract

Background: The diagnostic value and suitability of prostate cancer antigen 3 (PCA3) for the detection of prostate cancer (PCa) have been inconsistent in previous studies. Thus, the aim of the present meta-analysis was performed to systematically evaluate the diagnostic value of PCA3 for PCa. Materials and Methods: A meta-analysis was performed to search relevant studies using online databases EMBASE, PubMed and Web of Science published until February 1st, 2019. Ultimately, 65 studies met the inclusion criteria for this meta-analysis with 8.139 cases and 14.116 controls. The sensitivity, specificity, positive likelihood ratios (LR+), negative likelihood ratios (LR−), and other measures of PCA3 were pooled and determined to evaluate the diagnostic rate of PCa by the random-effect model. Results: With PCA3, the pooled overall diagnostic sensitivity, specificity, LR+, LR−, and 95% confidence intervals (CIs) for predicting significant PCa were 0.68 (0.64-0.72), 0.72 (0.68-0.75), 2.41 (2.16-2.69), 0.44 (0.40-0.49), respectively. Besides, the summary diagnostic odds ratio (DOR) and 95% CIs for PCA3 was 5.44 (4.53-6.53). In addition, the area under summary receiver operating characteristic (sROC) curves and 95% CIs was 0.76 (0.72-0.79). The major design deficiencies of included studies were differential verification bias, and a lack of clear inclusion and exclusion criteria. Conclusions: The results of this meta-analysis suggested that PCA3 was a non-invasive method with the acceptable sensitivity and specificity in the diagnosis of PCa, to distinguish between patients and healthy individuals. To validate the potential applicability of PCA3 in the diagnosis of PCa, more rigorous studies were needed to confirm these conclusions.

Review of commercially available biomarkers in the diagnosis of prostate cancer

“…[1] W dużej metaanalizie włączającej ponad 12 tysięcy pacjentów, czułość metody została określona na 65%, swoistość na 82%, przy NPV 90.0%. [1,12] PCA3 stał się także elementem kalkulatora ryzyka ERSPC, gdzie nieznacznie zwiększył detekcję raka prostaty (z 79% na 83%). [12] SelectMDx W badaniu SelectMDx mierzymy poziomy mRNA DLX1 i HOX6 w moczu po badaniu per rectum (DRE).…”

Up-Regulation of LINC00665 Facilitates the Malignant Progression of Prostate Cancer by Epigenetically Silencing KLF2 Through EZH2 and LSD1

“…LncRNA, a type of ncRNA with a transcript longer than 200 nt, does not encode proteins or only encodes short peptides ( 14 , 15 ) A large number of studies have revealed that lncRNA plays a non-negligible role in the development of PCa ( 21 , 22 ). Prostate cancer antigen 3 (PCA3), as one of the LncRNAs, has been proven to be a diagnostic marker to improve the diagnostic efficacy of PSA in PCa and has been approved by the FDA to guide repeated prostate biopsy ( 23 , 24 ). The lncRNA sequence contains nucleic acid binding sites and can be folded to form higher-level structures with corresponding protein-binding sites, which interacts with DNA, RNA, and proteins to affect the regulation of body functions ( 15 , 16 ).…”

Personalized management of prostate cancer: from molecular and imaging markers to radiogenomics

“…In recent years, a number of validated secondary oncomarkers, with improved specificity for PCa, appeared on the clinical scene and have already been included into American and European recommendations under the term “liquid biopsy”. Among them are such long non-coding urine-based mRNAs as Prostate Cancer Antigen 3 (PCA3) [ 4 ], HOXC6, DLX1 [ 5 ], and TMPRSS2-ERG (T2:ERG) [ 6 ], which are called on to help determine whether repeat puncture biopsy is needed after an initially negative biopsy. An example of a complex personalized approach to PCa risk calculation is incorporated into the Prostate Cancer Prevention Trial Risk Calculator patients’ clinical data, including levels of PSA, free PSA, and expression of PCA3 and T2:ERG.…”