Foj Laura, Milà Montserrat, Mengual Lourdes, Luque Pilar, Alcaraz Antonio, Jiménez Wladimiro, Filella Xavier
Department of Biochemistry and Molecular Genetics (CDB), Hospital Clínic, IDIBAPS, Barcelona, Catalonia, Spain.
Laboratory and Department of Urology, Hospital Clínic, IDIBAPS, Barcelona, Catalonia, Spain.
Clin Chim Acta. 2014 Aug 5;435:53-8. doi: 10.1016/j.cca.2014.04.025. Epub 2014 May 5.
The usefulness of PCA3 in the management of early prostate cancer (PCa) is on debate. The aim of this study was to evaluate PCA3 in the detection of PCa and its relationship with tumor aggressiveness.
PCA3 score was measured by real time PCR in urinary sediments of 122 patients who underwent prostate biopsy for PSA >4μg/L.
Analysis of ROC curves showed an area under the curve (AUC) of 0.804 for PCA3 score, while the AUCs were 0.587 and 0.697 for PSA and % free PSA, respectively. The probability of positive biopsy increased in relation to PCA3 score, with variations from 37% to 96% for patients with PCA3 score lower than 0.90 or higher than 1.04, respectively. We chose the cut-off value of 0.90, corresponding to a sensitivity of 92.5%, for which we obtained a specificity of 41.5%. No significant differences in PCA3 score were found in relation to Gleason score or clinical stage.
The results show a high probability of PCa in patients with an elevated PCA3 score, although we did not find any relationship with aggressiveness of the tumor. PCA3 score can help to select more precisely which patients will need to perform a biopsy of the prostate.
前列腺癌抗原3（PCA3）在早期前列腺癌（PCa）管理中的效用存在争议。本研究旨在评估PCA3在PCa检测中的作用及其与肿瘤侵袭性的关系。
对122例因前列腺特异性抗原（PSA）>4μg/L而接受前列腺活检的患者，通过实时聚合酶链反应（PCR）检测其尿沉渣中的PCA3评分。
ROC曲线分析显示，PCA3评分的曲线下面积（AUC）为0.804，而PSA和游离PSA百分比的AUC分别为0.587和0.697。活检阳性的概率随PCA3评分增加，PCA3评分低于0.90或高于1.04的患者，其概率分别从37%变化至96%。我们选择0.90作为临界值，对应敏感度为92.5%，此时特异度为41.5%。未发现PCA3评分与Gleason评分或临床分期存在显著差异。
结果表明，PCA3评分升高的患者患PCa的可能性很高，尽管我们未发现其与肿瘤侵袭性存在任何关系。PCA3评分有助于更精确地选择哪些患者需要进行前列腺活检。
