Division of Urology, Gradenigo Hospital, Italy.
BJU Int. 2012 Dec;110(11 Pt B):E778-82. doi: 10.1111/j.1464-410X.2012.11645.x. Epub 2012 Nov 1.
What's known on the subject? and What does the study add? While the relationship between PCA3 score and clinical or histological prostatitis was quite proven even in small patient groups, conversely the relationship between PCA3 score and HG-PIN is still under debate. We demonstrated in a large series (432 patients) that histologically documented chronic prostatitis and HG-PIN have similar PCA3 scores to patients with BPH and/or normal parenchyma at biopsy.
To determine whether histological chronic prostatitis and high-grade prostate intra-epithelial neoplasia (HG-PIN) influence the prostate cancer gene 3 (PCA3) score in Italian patients with an elevated prostate-specific antigen (PSA) level and a negative digital rectal examination (DRE) who were undergoing a first or repeat prostate biopsy.
A urinary PCA3 test was prospectively performed in 432 consecutive patients who were admitted to Gradenigo Hospital (Turin, Italy) between January and December 2011 and scheduled for first or repeat prostate biopsy as a result of an elevated PSA level and negative DRE. A comparison of the PCA3 score and patients with a negative biopsy (normal parenchyma, benign prostatic hyperplasia, chronic prostatitis, HG-PIN) or positive biopsy was performed.
PCA3 median (range) scores varied significantly (P < 0.001) in men with a negative vs positive biopsy: 33 (2-212) and 66 (5-324), respectively. By contrast, men with chronic prostatitis and HG-PIN showed no significant difference with respect to PCA3 score compared to other negative biopsy patients. No correlation was found between the number of positive cores for chronic prostatitis, HG-PIN and PCA3 score. Of all patients with a positive biopsy, 23 (20%) of 114 men had a PCA3 score ≤ 35. In total, 79 (40%) of 197 men with a negative biopsy (normal parenchyma and benign prostatic hyperplasia), 24 (37.5%) of 64 men with chronic prostatitis and 19 (39.6%) of 48 men with HG-PIN had a PCA3 score >35.
At this early stage of clinical evaluation, cancer specificity of the urinary PCA3 test appears to be maintained in the face of chronic prostatitis and HG-PIN.
确定组织学慢性前列腺炎和高级别前列腺上皮内瘤变（HG-PIN）是否会影响意大利患有升高的前列腺特异性抗原（PSA）水平和阴性数字直肠检查（DRE）并接受首次或重复前列腺活检的患者的前列腺癌基因 3（PCA3）评分。
在 2011 年 1 月至 12 月期间，连续 432 例因 PSA 水平升高和 DRE 阴性而计划进行首次或重复前列腺活检的患者在 Gradenigo 医院（意大利都灵）入组并前瞻性地进行了尿 PCA3 检测。对 PCA3 评分和阴性活检（正常实质、良性前列腺增生、慢性前列腺炎、HG-PIN）或阳性活检患者进行了比较。
阴性活检与阳性活检患者的 PCA3 中位数（范围）评分差异有统计学意义（P < 0.001）：分别为 33（2-212）和 66（5-324）。相比之下，慢性前列腺炎和 HG-PIN 患者的 PCA3 评分与其他阴性活检患者相比无显著差异。慢性前列腺炎阳性核心数、HG-PIN 和 PCA3 评分之间无相关性。在所有阳性活检患者中，114 名男性中有 23 名（20%）的 PCA3 评分≤35。在所有阴性活检患者（正常实质和良性前列腺增生）中，79 名（40%）、64 名慢性前列腺炎患者中 24 名（37.5%）和 48 名 HG-PIN 患者中 19 名（39.6%）的 PCA3 评分>35。
在临床评估的早期阶段，面对慢性前列腺炎和 HG-PIN，尿 PCA3 检测的癌症特异性似乎得以维持。
