Evaluation of the diagnostic and predictive power of PCA3 in the prostate cancer. A different best cut-off in each different scenario. Preliminary results
Introduction: Aim of this study is to evaluate the diagnostic performance of PCA3 in patients with indication to perform a new biopsy, according to the histological doubt such as High Grade Prostatic Intraepithelial Neoplasia (HGPIN) or Atypical Small Gland Proliferation (ASAP) or the clinical suspi...
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doaj-f62c611e26884fc48a8d08880f3540232020-11-25T03:21:38ZengPAGEPress PublicationsArchivio Italiano di Urologia e Andrologia1124-35622282-41972014-12-0186430631010.4081/aiua.2014.4.3064169Evaluation of the diagnostic and predictive power of PCA3 in the prostate cancer. A different best cut-off in each different scenario. Preliminary resultsGiuseppe Albino0Ettore Capoluongo1Sandro Rocchetti2Sara Palumbo3Cecilia Zuppi4Ettore Cirillo-Marucco5Operative Unit of Urology, ASL BAT, AndriaLaboratory of Clinical Molecular Biology, Institute of Clinical Biochemistry, Catholic University of Sacred Heart, RomaLaboratory of Clinical Molecular Biology, Institute of Clinical Biochemistry, Catholic University of Sacred Heart, RomaLaboratory of Clinical Molecular Biology, Institute of Clinical Biochemistry, Catholic University of Sacred Heart, RomaLaboratory of Clinical Molecular Biology, Institute of Clinical Biochemistry, Catholic University of Sacred Heart, RomaOperative Unit of Urology, ASL BAT, AndriaIntroduction: Aim of this study is to evaluate the diagnostic performance of PCA3 in patients with indication to perform a new biopsy, according to the histological doubt such as High Grade Prostatic Intraepithelial Neoplasia (HGPIN) or Atypical Small Gland Proliferation (ASAP) or the clinical suspicion. Materials and Methods: One hundred men were enrolled. We used the PCA3 - PROGENSA™ procedure. After the PCA3 test a repeated prostate biopsy was proposed. The histological findings were correlated to the PCA3 scores. We calculated the positive predictive value (PPV), the sensibility, the specificity, the Youden's index, the ROC curves, the area under the curve (AUC) for each cut-off value of PCA3 score. Results: These results are preliminary, because at present only 50 of the 100 enlisted men were subjected to rebiopsy. We calculated the best cut-off PCA3 score 20 at the first diagnosis; for patients with HGPIN or ASAP at first biopsy the best sensitivity cut-off is 45; the best cutoff is 45 when you already have a diagnosis of HGPIN, and 35 for ASAP. If we normalize the PCA3 score to the prostate volume, the best cut-off would be 20, with 100% sensitivity with a prostate volume of 65 ml. All results are statistically significant. The real problem, also present in literature, is the constant presence of not diagnosed prostate cancers, for any cut-off value. Conclusions: Our preliminary results suggest that, to get the best diagnostic performance, it would be wrong to maintain a single cut-off, but it should be chosen according to the scenario of the patients subgroup. It is to explore the possibility to search for the PCA3 in the serum to bridge the gap of the aggressive PCa missed by the urinary test.http://www.pagepressjournals.org/index.php/aiua/article/view/5039Prostate CAncer gene 3 (PCA3) scoreRepeated biopsiesBest cut-offHigh Grade Prostatic Intraepithelial Neoplasia (HGPIN)Atypical Small Gland Proliferation (ASAP)Prostate cancer |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Giuseppe Albino Ettore Capoluongo Sandro Rocchetti Sara Palumbo Cecilia Zuppi Ettore Cirillo-Marucco |
spellingShingle |
Giuseppe Albino Ettore Capoluongo Sandro Rocchetti Sara Palumbo Cecilia Zuppi Ettore Cirillo-Marucco Evaluation of the diagnostic and predictive power of PCA3 in the prostate cancer. A different best cut-off in each different scenario. Preliminary results Archivio Italiano di Urologia e Andrologia Prostate CAncer gene 3 (PCA3) score Repeated biopsies Best cut-off High Grade Prostatic Intraepithelial Neoplasia (HGPIN) Atypical Small Gland Proliferation (ASAP) Prostate cancer |
author_facet |
Giuseppe Albino Ettore Capoluongo Sandro Rocchetti Sara Palumbo Cecilia Zuppi Ettore Cirillo-Marucco |
author_sort |
Giuseppe Albino |
title |
Evaluation of the diagnostic and predictive power of PCA3 in the prostate cancer. A different best cut-off in each different scenario. Preliminary results |
title_short |
Evaluation of the diagnostic and predictive power of PCA3 in the prostate cancer. A different best cut-off in each different scenario. Preliminary results |
title_full |
Evaluation of the diagnostic and predictive power of PCA3 in the prostate cancer. A different best cut-off in each different scenario. Preliminary results |
title_fullStr |
Evaluation of the diagnostic and predictive power of PCA3 in the prostate cancer. A different best cut-off in each different scenario. Preliminary results |
title_full_unstemmed |
Evaluation of the diagnostic and predictive power of PCA3 in the prostate cancer. A different best cut-off in each different scenario. Preliminary results |
title_sort |
evaluation of the diagnostic and predictive power of pca3 in the prostate cancer. a different best cut-off in each different scenario. preliminary results |
publisher |
PAGEPress Publications |
series |
Archivio Italiano di Urologia e Andrologia |
issn |
1124-3562 2282-4197 |
publishDate |
2014-12-01 |
description |
Introduction: Aim of this study is to evaluate the diagnostic performance of PCA3 in patients with indication to perform a new biopsy, according to the histological doubt such as High Grade Prostatic Intraepithelial Neoplasia (HGPIN) or Atypical Small Gland Proliferation (ASAP) or the clinical suspicion. Materials and Methods: One hundred men were enrolled. We used the PCA3 - PROGENSA™ procedure. After the PCA3 test a repeated prostate biopsy was proposed. The histological findings were correlated to the PCA3 scores. We calculated the positive predictive value (PPV), the sensibility, the specificity, the Youden's index, the ROC curves, the area under the curve (AUC) for each cut-off value of PCA3 score. Results: These results are preliminary, because at present only 50 of the 100 enlisted men were subjected to rebiopsy. We calculated the best cut-off PCA3 score 20 at the first diagnosis; for patients with HGPIN or ASAP at first biopsy the best sensitivity cut-off is 45; the best cutoff is 45 when you already have a diagnosis of HGPIN, and 35 for ASAP. If we normalize the PCA3 score to the prostate volume, the best cut-off would be 20, with 100% sensitivity with a prostate volume of 65 ml. All results are statistically significant. The real problem, also present in literature, is the constant presence of not diagnosed prostate cancers, for any cut-off value. Conclusions: Our preliminary results suggest that, to get the best diagnostic performance, it would be wrong to maintain a single cut-off, but it should be chosen according to the scenario of the patients subgroup. It is to explore the possibility to search for the PCA3 in the serum to bridge the gap of the aggressive PCa missed by the urinary test. |
topic |
Prostate CAncer gene 3 (PCA3) score Repeated biopsies Best cut-off High Grade Prostatic Intraepithelial Neoplasia (HGPIN) Atypical Small Gland Proliferation (ASAP) Prostate cancer |
url |
http://www.pagepressjournals.org/index.php/aiua/article/view/5039 |
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