Department of Medical Unit of Molecular Oncology and Transfer, Medical Faculty of Lyon 1 University, Lyon, France.
J Urol. 2011 Apr;185(4):1234-9. doi: 10.1016/j.juro.2010.11.072. Epub 2011 Feb 22.
The urinary PCA3 gene test has proved helpful for deciding whether to (re)biopsy to diagnose prostate cancer. We searched for pathological features that influence the shedding of PCA3 producing prostate cancer cells in urine after digital rectal examination.
Included in our study were 102 patients with an informative PCA3 score on the Progensa® PCA3 assay who underwent radical prostatectomy. Correlations were evaluated between PCA3 score and histopathological factors on prostatectomy, including tumor site in the prostate and the number of cancer foci.
PCA3 score significantly correlated with total tumor volume in prostatectomy specimens (p <0.001) but not with prostatectomy Gleason score or pathological stage. PCA3 score positively correlated with apical and basal invasion, and with bilaterality and multifocality. On multivariate analysis multifocality was an independent factor influencing PCA3 score (p = 0.012).
Site in the prostate gland and the number of cancer foci may explain the observed PCA3 score variation in patients operated on for prostate cancer. The PCA3 test could be helpful in preoperatively selecting patients with unifocal and unilateral cancer who could benefit from active surveillance or focal therapy.
PCA3 基因检测在决定是否进行（重新）活检以诊断前列腺癌方面已被证明具有一定帮助。我们研究了影响经直肠指检（DRE）后 PCA3 产生的前列腺癌细胞在尿液中脱落的病理特征。
本研究纳入了 102 例经 Progensa® PCA3 检测有信息价值的 PCA3 评分的患者，这些患者均接受了根治性前列腺切除术。我们评估了 PCA3 评分与前列腺切除术的组织病理学因素之间的相关性，包括前列腺肿瘤部位和癌灶数量。
PCA3 评分与前列腺切除标本的总肿瘤体积显著相关（p<0.001），但与前列腺切除术 Gleason 评分或病理分期无关。PCA3 评分与肿瘤累及前列腺尖部和底部、肿瘤双侧累及和多灶性呈正相关。多因素分析显示，多灶性是影响 PCA3 评分的独立因素（p=0.012）。
前列腺内肿瘤部位和癌灶数量可以解释前列腺癌患者 PCA3 评分的变化。PCA3 检测可有助于术前选择适合主动监测或局部治疗的单侧、单灶性前列腺癌患者。
