De Luca Stefano, Passera Roberto, Cappia Susanna, Bollito Enrico, Randone Donato Franco, Porpiglia Francesco
Urology, San Luigi Gonzaga Hospital and University of Torino, Orbassano, Italy.
Nuclear Medicine, San Giovanni Battista Hospital and University of Torino, Torino, Italy
Anticancer Res. 2015 Apr;35(4):2417-22.
To evaluate pathological patterns of prostate biopsy in men with changes in risk class by prostate cancer gene 3 (PCA3) score and with elevated serum prostate-specific antigen (PSA) or positive digital rectal examination (DRE), undergoing a repeat biopsy.
A total of 108 males of two Italian Institutions who had undergone at least two PCA3 score assessments with changed PCA3 risk class were selected. Comparison of PCA3 score in patients with negative re-biopsy [normal parenchyma, benign prostatic hyperplasia (BPH), chronic prostatitis, high-grade prostate intraepithelial neoplasia (HG-PIN), atypical small acinar prostate (ASAP)] or positive re-biopsy was performed.
The up- and down-grading rates for PCA3 score were 71.3% (n=77) and 28.7% (n=31), respectively. Among the 77 up-graded patients, the median change in PCA3 score was 24 (range=4-69), while among the 31 down-graded ones, the median change was 17 (2 to 55). The PCA3 score in 24 out of 29 (82.7%) patients with prostate cancer (PCa) was up-graded. No association was found for correlation of PCA3 score change with age >65 years (p=0.975), family history of prostate cancer (p=0.796), positive DRE (p=0.179), use of 5-alpha-reductase inhibitors (p=0.793) and BPH/prostatitis/HG-PIN/ASAP diagnosis (p=0.428).
PCA3 score can be considered a marker that is stable over time in most cases; notably, up to 20% of patients have a clinically relevant change of risk class. The rate of PCa was higher in patients whose PCA3 score was up-graded, even if no robust cut-off for PCA3 score fluctuation was identified.
通过前列腺癌基因3（PCA3）评分评估风险等级发生变化且血清前列腺特异性抗原（PSA）升高或直肠指检（DRE）阳性的男性患者重复活检时前列腺活检的病理模式。
选取了两个意大利机构的108名男性，他们至少接受过两次PCA3评分评估且PCA3风险等级发生了变化。对再次活检阴性（正常实质、良性前列腺增生（BPH）、慢性前列腺炎、高级别前列腺上皮内瘤变（HG-PIN）、非典型小腺泡前列腺（ASAP））或阳性患者的PCA3评分进行比较。
PCA3评分的升级和降级率分别为71.3%（n = 77）和28.7%（n = 31）。在77名升级患者中，PCA3评分的中位数变化为24（范围 = 4 - 69），而在31名降级患者中，中位数变化为17（2至55）。29名前列腺癌（PCa）患者中有24名（82.7%）的PCA3评分升级。未发现PCA3评分变化与年龄>65岁（p = 0.97）、前列腺癌家族史（p = 0.796）、DRE阳性（p = 0.179）、5-α还原酶抑制剂的使用（p = 0.793）以及BPH/前列腺炎/HG-PIN/ASAP诊断（p = 0.428）之间存在相关性。
PCA3评分在大多数情况下可被视为随时间稳定的标志物；值得注意的是，高达20%的患者风险等级发生了具有临床意义的变化。PCA3评分升级的患者中PCa的发生率更高，即使未确定PCA3评分波动的确切临界值。（注：原文中“p = 0.97”疑似有误，根据上下文推测应为“p = 0.975”，译文已修正）
