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PSCA mRNA expression in preoperatively negative prostate biopsies predicts incidental prostate cancer in patients undergoing transurethral resection of the prostate for benign prostatic hyperplasia
Author(s) -
Zhao Zhigang,
Ma Wenjing,
Zeng Guohua,
Qi Defeng
Publication year - 2011
Publication title -
journal of surgical oncology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.201
H-Index - 111
eISSN - 1096-9098
pISSN - 0022-4790
DOI - 10.1002/jso.21996
Subject(s) - medicine , prostate cancer , prostate , urology , transurethral resection of the prostate , biopsy , concordance , hyperplasia , proportional hazards model , pca3 , messenger rna , cancer , oncology , pathology , gene , biology , biochemistry
Background Recent data showed that prostate stem cell antigen (PSCA) mRNA expression is predictive of the subsequent cancer in BPH patients treated with TURP. This study was to determine whether PSCA mRNA expression in preoperatively negative biopsies identified the presence of incidental prostate cancer (IPCa) on TURP tissues analysis. Methods PSCA in situ hybridization was performed in preoperatively negative prostatic biopsies taken from 592 enrolled BPH patients. Predictive performance of PSCA mRNA for IPCa was evaluated by the Cox proportional hazards models. Results PSCA mRNA positivity in negative biopsy specimens was detected in 84 (14.2%) of 592 men. Of those 84 patients, 57 were histopathologically identified as having PCa on their TURP tissues. None of the rest 508 men with negative PSCA mRNA expression were diagnosed with IPCa. Spearman's rank correlation coefficient showed that PSCA mRNA expression levels were correlated significantly and positively with Gleason score (r = 0.80, P < 0.001) and clinical stage (r = 0.86, P < 0.001). A multivariate Cox model demonstrated that only PSCA mRNA positivity was predictive of the IPCa presence on TURP (HR = 4.04; 95% CI: 2.12–5.42; P < 0.001), with the concordance index of 0.878. Conclusion PSCA mRNA positivity in negative biopsies is a promising marker for the presence of IPCa in BPH patients. J. Surg. Oncol. 2011; 104:672–678. © 2011 Wiley Periodicals, Inc.