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Vol. 85, No. 2, 2010
Issue release date: September 2010
Urol Int 2010;85:159–165

Interpretation of the Prostate Cancer Gene 3 in Reference to the Individual Clinical Background: Implications for Daily Practice

Schilling D. · Hennenlotter J. · Munz M. · Bökeler U. · Sievert K.-D. · Stenzl A.
Department of Urology, University Hospital Tübingen, Tübingen, Germany

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Introduction: The prostate cancer gene 3 (PCA3) urine assay for the diagnosis of prostate cancer was introduced into clinical practice at the end of 2006. We report our experience with the test in a routine clinical setting and discuss the interpretation of the test results in the context of the individual patient history. Material and Methods: We retrospectively reviewed the data of all patients who received PCA3 determination during a visit to our outpatient clinic between January and June 2008. Prostate volume, prostate-specific antigen (PSA) and (in cases where a biopsy was performed) the biopsy results were collected. Results: The PCA3 score was independent of prostate volume and serum PSA. In our study population, 56 men had a negative (<35) and 47 a positive score (≧35). Thirty-two patients were subsequently biopsied, 18 of which were diagnosed with prostate cancer (51%). Patients with a positive biopsy showed significantly higher PCA3 values (p < 0.05). Sensitivity was 94%, specificity was 36% and the negative predictive value was 83%. The area under the curve in the receiver operating characteristics was 0.81 for the PCA3 score and 0.61 for the serum PSA. Conclusion: The PCA3 value correlates with the probability of a positive prostate biopsy. The high negative predictive value can facilitate the decision for or against a prostate biopsy. However, the low specificity and the comparably high costs hamper the routine use for prostate cancer screening purposes. To increase specificity, in daily practice the PCA3 score should be interpreted carefully with reference to the absolute PSA value and clinical history.

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  1. Thompson IM, Pauler DK, Goodman PJ, Tangen CM, Lucia MS, Parnes HL, Minasian LM, Ford LG, Lippman SM, Crawford ED, Crowley JJ, Coltman CA Jr: Prevalence of prostate cancer among men with a prostate-specific antigen level < or = 4.0 ng per milliliter. N Engl J Med 2004;350:2239–2246.
  2. Pelzer AE, Tewari A, Bektic J, Berger AP, Frauscher F, Bartsch G, Horninger W: Detection rates and biologic significance of prostate cancer with PSA less than 4.0 ng/ml: observation and clinical implications from Tyrol screening project. Urology 2005;66:1029–1033.
  3. Loch T: Innovative approaches in prostate cancer ultrasound (in German). Urologe A 2006;45:694–698.
  4. Mitterberger M, Horninger W, Pelzer A, Strasser H, Bartsch G, Moser P, Halpern EJ, Gradl J, Aigner F, Pallwein L, Frauscher F: A prospective randomized trial comparing contrast-enhanced targeted versus systematic ultrasound guided biopsies: impact on prostate cancer detection. Prostate 2007;67:1537–1542.
  5. Parekh DJ, Ankerst DP, Troyer D, Srivastava S, Thompson IM: Biomarkers for prostate cancer detection. J Urol 2007;178:2252–2259.
  6. Oberpenning F, von Knobloch R, Sprute W, Roth S, Rathert M, Bierer S, Gerss J, Semjonow A: DiaPat urine test for prostate cancer: predictive value for results of transrectal ultrasound-guided prostate biopsies (in German). Urologe A 2008;47:735–739.
  7. Hessels D, Klein Gunnewiek JM, van Oort I, Karthaus HF, van Leenders GJ, van Balken B, Kiemeney LA, Witjes JA, Schalken JA: DD3(PCA3)-based molecular urine analysis for the diagnosis of prostate cancer. Eur Urol 2003;44:8–15.
  8. Hease A, Van Poppel H, Marberger M, Mulders P, Abbou CC, Boccon-Gibod L, Stenzl A, Huland H, De La Taille A, Schalken J: The value of the PCA3 assay in guiding decision which men with a negative prostate biopsy need immediate repeat biopsy: preliminary European data. Eur Urol Suppl 2007;6:48.

    External Resources

  9. Anastasiadis AG, Lichy MP, Nagele U, Kuczyk MA, Merseburger AS, Hennenlotter J, Corvin S, Sievert KD, Claussen CD, Stenzl A, Schlemmer HP: MRI-guided biopsy of the prostate increases diagnostic performance in men with elevated or increasing PSA levels after previous negative TRUS biopsies. Eur Urol 2006;50:738–748.
  10. Recker F, Kwiatkowski MK, Huber A, Stamm B, Lehmann K, Tscholl R: Prospective detection of clinically relevant prostate cancer in the prostate specific antigen range 1 to 3 ng./ml. combined with free-to-total ratio 20% or less: the Aarau experience. J Urol 2001;166:851–855.
  11. Groskopf J, Aubin SM, Deras IL, Blase A, Bodrug S, Clark C, Brentano S, Mathis J, Pham J, Meyer T, Cass M, Hodge P, Macairan ML, Marks LS, Rittenhouse H: APTIMA PCA3 molecular urine test: development of a method to aid in the diagnosis of prostate cancer. Clin Chem 2006;52:1089–1095.
  12. Marks LS, Fradet Y, Deras IL, Blase A, Mathis J, Aubin SM, Cancio AT, Desaulniers M, Ellis WJ, Rittenhouse H, Groskopf J: PCA3 molecular urine assay for prostate cancer in men undergoing repeat biopsy. Urology 2007;69:532–535.
  13. van Gils MP, Hessels D, van Hooij O, Jannink SA, Peelen WP, Hanssen SL, Witjes JA, Cornel EB, Karthaus HF, Smits GA, Dijkman GA, Mulders PF, Schalken JA: The time-resolved fluorescence-based PCA3 test on urinary sediments after digital rectal examination; a Dutch multicenter validation of the diagnostic performance. Clin Cancer Res 2007;13:939–943.
  14. Nakanishi H, Groskopf J, Fritsche HA, Bhadkamkar V, Blase A, Kumar SV, Davis JW, Troncoso P, Rittenhouse H, Babaian RJ: PCA3 molecular urine assay correlates with prostate cancer tumor volume: implication in selecting candidates for active surveillance. J Urol 2008;179:1804–1809.
  15. Deras IL, Aubin SM, Blase A, Day JR, Koo S, Partin AW, Ellis WJ, Marks LS, Fradet Y, Rittenhouse H, Groskopf J: PCA3: a molecular urine assay for predicting prostate biopsy outcome. J Urol 2008;179:1587–1592.
  16. Haese A, de la Taille A, van Poppel H, Marberger M, Stenzl A, Mulders PF, Huland H, Abbou CC, Remzi M, Tinzl M, Feyerabend S, Stillebroer AB, van Gils MP, Schalken JA: Clinical utility of the PCA3 urine assay in European men scheduled for repeat biopsy. Eur Urol 2008;54:1081–1088.
  17. Chun FK, de la Taille A, van Poppel H, Marberger M, Stenzl A, Mulders PF, Huland H, Abbou CC, Stillebroer AB, van Gils MP, Schalken JA, Fradet Y, Marks LS, Ellis W, Partin AW, Haese A: Prostate cancer gene 3 (PCA3): development and internal validation of a novel biopsy nomogram. Eur Urol 2009;56:659–667.
  18. Whitman EJ, Groskopf J, Ali A, Chen Y, Blase A, Furusato B, Petrovics G, Ibrahim M, Elsamanoudi S, Cullen J, Sesterhenn IA, Brassell S, Rittenhouse H, Srivastava S, McLeod DG: PCA3 score before radical prostatectomy predicts extracapsular extension and tumor volume. J Urol 2008;180:1975–1978.
  19. Groskopf J, Blase A, Koo S, Deras IL, Aubin SMJ, Rittenhouse H, Marks L, Fradet Y: The PCA3 score is independent of prostate gland volume, and can synergize with other patient information for predicting biopsy outcome. Eur Urol Suppl 2007;6:48.

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