The value of urinary prostate cancer gene 3 (PCA3) scores in predicting pathological features at radical prostatectomy

Abstract

Study Type – Diagnostic (exploratory cohort) Level of Evidence 2b What's known on the subject? and What does the study add? PCA3 scores correlate to numerous histoprognostic factors, specifically tumour volume and positive surgical margins. These results may have a clinical impact in the near future on the selection of patients eligible to undergo active surveillance and nerve‐sparing surgery. OBJECTIVE To assess correlations between Prostate CAncer gene 3 (PCA3) levels and pathological features of radical prostatectomy (RP) specimens, which define cancer aggressiveness. PATIENTS AND METHODS After digital rectal examination (DRE), first‐catch urine was collected from 160 patients with localized prostate cancer. The PCA3 score was calculated using the Gene Probe Progensa™ assay. PCA3 scores were then correlated to the pathological features of the RP specimens. RESULTS PCA3 scores correlated significantly with tumour volume (r= 0.34, P < 0.01). A PCA3 score of >35 was an independent predictor in a multivariate analysis of a tumour volume >0.5 mL (odds ratio [OR] 2.7, P= 0.04). It was also an independent predictor of positive surgical margins (OR 2.4, P= 0.04). Receiver–operator characteristic curves indicated PCA3 as the most accurate predictor of positive margins (area under the curve [AUC] 0.62), in addition to a positive biopsy percentage (AUC 0.52). There was also a significant difference in the mean PCA3 score between Gleason score patient groups (6 vs ≥7) and pathological stage groups (pT0/2 vs pT3/4). CONCLUSIONS PCA3 scores correlate to numerous histoprognostic factors, specifically tumour volume and positive surgical margins. These results may have a clinical impact in the near future on the selection of patients eligible to undergo active surveillance and nerve‐sparing surgery.

Combination of real-time elastography and urine prostate cancer gene 3 (PCA3) detects more than 97% of significant prostate cancers

“…However, different thresholds could be appropriate in various clinical situations [8]. In contrast to Durand et al [18], no significant correlation between PCA3 score and tumour volume was found in the present study.…”

TMPRSS2-ERG Fusion Transcripts in Matched Urine and Needle Rinse Material after Biopsy for the Detection of Prostate Cancer

“…Other prostate cancer-specific genes, including PCA3 (prostate cancer antigen 3) (6 ), 6 TMPRSS2-ERG (transmembrane protease, serine 2) (7 ), DNA methylation (8 ), ERG (v-ets erythroblastosis virus E26 oncogene homolog) (9 ), annexin A3, and sarcosine, some of which have been proposed in combination (10,11 ), have raised enthusiasm throughout the scientific community. To date, however, the only two markers that appear clinically relevant are PCA3 and TMPRSS2-ERG (12,13 ).…”

High-risk prostate cancer—classification and therapy

“…Urinary PCA3 level has been correlated with Gleason score and tumor volume in radical prostatectomy specimens, though its use in identifying high-risk disease that would otherwise be undetected is uncertain. 23, 24 Another genetic biomarker, the Prolaris ® test, is a 46-gene panel associated with tumour proliferation d 25 that is being marketed by Myriad Genetics (Salt Lake City, Utah). This 46-gene panel biomarker is designed to determine which tumors that are categorized as “low-risk” may be more aggressive and thus not appropriate for an active surveillance approach.…”