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Follow‐up of men with an elevated PCA3 score and a negative biopsy: does an elevated PCA3 score indeed predict the presence of prostate cancer?
Author(s) -
Remzi Mesut,
Haese Alexander,
Van Poppel Hein,
De La Taille Alexandre,
Stenzl Arnulf,
Hennenlotter Jörg,
Marberger Michael
Publication year - 2010
Publication title -
bju international
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.773
H-Index - 148
eISSN - 1464-410X
pISSN - 1464-4096
DOI - 10.1111/j.1464-410x.2010.09330.x
Subject(s) - prostate cancer , gynecology , medicine , biopsy , pca3 , intraepithelial neoplasia , prostate , prostate biopsy , urology , cancer , oncology
Study Type – Diagnosis (exploratory cohort)
Level of Evidence 2b OBJECTIVE To describe the follow‐up of men with an elevated ‘Prostate CAncer gene 3’ (PCA3, a promising novel tool for prostate cancer detection) and a negative repeat biopsy (Bx‐), as a previous study in men with one or two negative Bx (Bx−) scheduled for repeat Bx showed that a higher PCA3 score corresponded with a higher probability of a positive repeat Bx (Bx+). PATIENTS AND METHODS This study comprised an analysis of the follow‐up of men with a PCA3 score of ≥20 and a repeat Bx−, after which a follow‐up Bx was taken. The initial study data in 463 men were also analysed to compare characteristics of: (i) men with a PCA3 score of ≥20 and ≥35 and a repeat Bx+, vs those with a Bx−; and (ii) men with a repeat Bx− and a PCA3 score of ≥20 vs <20 and a PCA3 score of ≥35 vs <35. RESULTS A follow‐up Bx was taken in 51 selected men; the Bx+ rate was 55%. Men with a follow‐up Bx+ had a higher PCA3 score (mean 69.5, median 50.4) than those with a Bx− (mean 37.7, median 28.2; P < 0.001). They also more often had high‐grade prostatic intraepithelial neoplasia (HGPIN) at the previous Bx (46% vs 17%; P = 0.029). Men with a PCA3 score of ≥35 and a repeat Bx+ had a higher PCA3 score (mean 113.9, median 75.7) than those with a Bx− (mean 87.3, median 56.9; P = 0.047). Men with a repeat Bx− and an elevated/high PCA3 score more often had HGPIN than men with a low PCA3 score. CONCLUSIONS An elevated/high PCA3 score can predict prostate cancer in men with one or two previous Bx−. If the repeat Bx is negative, an elevated/high PCA3 score combined with HGPIN might predict prostate cancer at the follow‐up Bx.