Nakanishi Hiroyuki, Groskopf Jack, Fritsche Herbert A, Bhadkamkar Viju, Blase Amy, Kumar S Vikas, Davis John W, Troncoso Patricia, Rittenhouse Harry, Babaian R Joseph
Department of Urology, The University of Texas M. D. Anderson Cancer Center, Houston, Texas 77030, USA.
J Urol. 2008 May;179(5):1804-9; discussion 1809-10. doi: 10.1016/j.juro.2008.01.013. Epub 2008 Mar 18.
Prostate cancer gene 3 (PCA3) has shown promise as a molecular marker in prostate cancer detection. We assessed the association of urinary PCA3 score with prostatectomy tumor volume and other clinical and pathological features.
Urine specimens were collected after digital rectal examination from 59 men scheduled for prostate biopsy and 83 men scheduled for radical prostatectomy. Prostatectomy findings were evaluable for 96 men. PCA3 and prostate specific antigen mRNAs were quantified with Gen-Probe DTS 400 System. The PCA3 score was defined as the ratio of PCA3 mRNA/prostate specific antigen mRNA x10(3).
The PCA3 score in men with negative biopsies (30) and positive biopsies (29) were significantly different (median 21.1 and 31.0, respectively, p = 0.029). The PCA3 score was significantly correlated with total tumor volume in prostatectomy specimens (r = 0.269, p = 0.008), and was also associated with prostatectomy Gleason score (6 vs 7 or greater, p = 0.005) but not with other clinical and pathological features. The PCA3 score was significantly different when comparing low volume/low grade cancer (dominant tumor volume less than 0.5 cc, Gleason score 6) and significant cancer (p = 0.007). On multivariate analysis PCA3 was the best predictor of total tumor volume in prostatectomy (p = 0.001). Receiver operating characteristic curve analysis showed that the PCA3 score could discriminate low volume cancer (total tumor volume less than 0.5 cc) well with area under the curve of 0.757.
The PCA3 score appears to stratify men based on prostatectomy tumor volume and Gleason score, and may have clinical applicability in selecting men who have low volume/low grade cancer.
前列腺癌基因3（PCA3）已显示出作为前列腺癌检测分子标志物的前景。我们评估了尿PCA3评分与前列腺切除肿瘤体积及其他临床和病理特征之间的关联。
在直肠指检后，收集了59名计划进行前列腺活检的男性和83名计划进行根治性前列腺切除术的男性的尿液标本。96名男性的前列腺切除结果可进行评估。使用Gen-Probe DTS 400系统对PCA3和前列腺特异性抗原mRNA进行定量。PCA3评分定义为PCA3 mRNA/前列腺特异性抗原mRNA×10(3)的比值。
活检阴性（30例）和活检阳性（29例）男性的PCA3评分有显著差异（中位数分别为21.1和31.0，p = 0.029）。PCA3评分与前列腺切除标本中的肿瘤总体积显著相关（r = 0.269，p = 0.008），也与前列腺切除Gleason评分相关（6分与7分或更高，p = 0.005），但与其他临床和病理特征无关。比较小体积/低级别癌（主要肿瘤体积小于0.5 cc，Gleason评分6分）和显著癌时，PCA3评分有显著差异（p = 0.007）。多因素分析显示，PCA3是前列腺切除术中肿瘤总体积的最佳预测指标（p = 0.001）。受试者操作特征曲线分析表明，PCA3评分能够很好地区分小体积癌（肿瘤总体积小于0.5 cc），曲线下面积为0.757。
PCA3评分似乎可根据前列腺切除肿瘤体积和Gleason评分对男性进行分层，在选择小体积/低级别癌男性患者方面可能具有临床适用性。
