PCA3 Score Before Radical Prostatectomy Predicts Extracapsular Extension and Tumor Volume
Received 27 March 2008 published online 17 September 2008.
Refers to article:
The Significance of Monoamine Oxidase-A Expression in High Grade Prostate Cancer
, 22 September 2008
Donna M. Peehl, Marc Coram, Htet Khine, Stephen Reese, Rosalie Nolley, Hongjuan Zhao
The Journal of Urology
November 2008 (Vol. 180, Issue 5, Pages 2206-2211) Abstract |
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Purpose
PCA3 is a prostate specific, nonprotein coding RNA that is over expressed in prostate cancer. Recent studies showed the diagnostic potential of a urine based PCA3 for predicting biopsy outcome. We assessed the relationship between urine PCA3 and pathological features in whole mount radical prostatectomy specimens.
Materials and Methods
Post-digital rectal examination urine specimens were obtained from 72 men with prostate cancer before radical prostatectomy. PCA3 and PSA mRNA were measured. The ratio of PCA3 to PSA mRNA was recorded as a PCA3 score and correlated with data on each prostate specimen.
Results
Patients with extracapsular extension had a significantly higher median PCA3 score than patients without extracapsular extension (48.8 vs 18.7, p = 0.02). PCA3 score significantly correlated with total tumor volume (r = 0.38, p <0.01). On multivariate analysis PCA3 score was an independent predictor of extracapsular extension (p = 0.01) and total tumor volume less than 0.5 cc (p = 0.04). At a cutoff PCA3 score of 47 extracapsular extension was predicted with 94% specificity and an 80% positive predictive value. When combined with serum PSA and biopsy Gleason score, the ROC AUC for predicting extracapsular extension was 0.90.
Conclusions
PCA3 detected in the post-digital rectal examination urine of patients with prostate cancer correlated with pathological findings. Therefore, it could provide prognostic information. To our knowledge this is the first report of a molecular urine assay that predicts extracapsular extension.
Urology Service, Walter Reed Army Medical Center (EJW, SB, DGM) and Department of Genito-Urinary Pathology, Armed Forces Institute of Pathology (IAS, BF), Washington, D. C., Center for Prostate Disease Research (EJW, AA, YC, BF, GP, MI, SE, JC, SS, DGM), Department of Surgery, Uniformed Services University (GP, SB, SS, DGM), Bethesda, Maryland, and Gen-Probe, Inc., San Diego, California
Correspondence: Center for Prostate Disease Research, Department of Surgery, Urology Service, Walter Reed Army Medical Center, Washington, D. C. 20307 (telephone: 202-782-4000; FAX: 202-782-2310)
Study received institutional review board approval.
Supported by a grant from Gen-Probe, Inc., San Diego, California (DGM, SS).
For another article on a related topic see page 2206.
⁎ Financial interest and/or other relationship with Gen-Probe.
ABSTRACT