Department of Molecular Medicine, KSMD, KNUST, Ghana.
Urology Unit, 37 Military Hospital, Accra, Ghana.
Dis Markers. 2022 Oct 7;2022:1686991. doi: 10.1155/2022/1686991. eCollection 2022.
Prostate cancer is one of the most commonly diagnosed cancers in men. Prostate-specific antigen (PSA) has been the biomarker of choice for screening and diagnosis of prostate cancer. However, inefficiencies exist with its diagnostic capabilities. This study thus evaluated the diagnostic and prognostic potential of urinary PCA3 as an alternative biomarker for prostate cancer in the Ghanaian population.
A hospital-based cross-sectional study was conducted at the Urology Department of the 37 Military Hospital, Accra, Ghana. A total of 237 participants aged 40 years and above with any form of suspected prostate disorder were recruited into the study after written informed consent was obtained. Total serum PSA levels was measured using the electrochemiluminescence method and transrectal ultrasound-guided systematic core needle biopsies were obtained from each study participant. Receiver operating characteristic curve (ROC) analysis was used to evaluate the diagnostic accuracies of serum PSA, DRE, and PCA3 as diagnostic tools for prostate cancer. These three diagnostic tools were also evaluated in various combinations to ascertain the combinations with the best diagnostic accuracy.
Prostate cancer was diagnosed in 26.6% of the participants. Benign prostate hyperplasia and prostatitis were diagnosed in 48.5% and 24.9% participants, respectively. DRE had a sensitivity of 93.7% and a specificity of 12.1%. PSA had a sensitivity of 92.1% and a specificity of 16.1%. PCA3 had a sensitivity of 57.1% and a specificity of 85.6% and showed a better accuracy (AUC = 83.0) compared to PSA (AUC = 60.0) and DRE (AUC = 65.0) as individual diagnostic tools. The combination of DRE+PCA3 score had the best diagnostic accuracy (AUC = 0.80) with a sensitivity and specificity of 60.3% and 80.5%, respectively.
The urinary PCA3 assay showed a better diagnostic performance compared to serum PSA and DRE. PCA3 as a stand-alone and in combination with DRE could be a suitable complimentary marker in diagnosis and management of prostate cancer.
前列腺癌是男性最常见的癌症之一。前列腺特异性抗原（PSA）一直是前列腺癌筛查和诊断的首选生物标志物。然而，其诊断能力存在效率低下的问题。本研究因此评估了尿 PCA3 作为加纳人群前列腺癌替代生物标志物的诊断和预后潜力。
这是一项在加纳阿克拉 37 军医院泌尿科进行的基于医院的横断面研究。共招募了 237 名年龄在 40 岁及以上、有任何形式疑似前列腺疾病的参与者，在获得书面知情同意后纳入研究。使用电化学发光法测量总血清 PSA 水平，并从每位研究参与者中获得经直肠超声引导的系统核心针活检。受试者工作特征曲线（ROC）分析用于评估血清 PSA、DRE 和 PCA3 作为前列腺癌诊断工具的诊断准确性。还评估了这三种诊断工具的各种组合，以确定具有最佳诊断准确性的组合。
在 26.6%的参与者中诊断出前列腺癌。良性前列腺增生和前列腺炎分别在 48.5%和 24.9%的参与者中诊断出。DRE 的灵敏度为 93.7%，特异性为 12.1%。PSA 的灵敏度为 92.1%，特异性为 16.1%。PCA3 的灵敏度为 57.1%，特异性为 85.6%，与 PSA（AUC=60.0）和 DRE（AUC=65.0）相比，作为个体诊断工具，具有更好的准确性（AUC=83.0）。DRE+PCA3 评分组合的诊断准确性最佳（AUC=0.80），灵敏度和特异性分别为 60.3%和 80.5%。
尿 PCA3 检测与血清 PSA 和 DRE 相比具有更好的诊断性能。PCA3 作为一种独立的标志物，以及与 DRE 联合使用，可能是前列腺癌诊断和管理的一种合适的补充标志物。
