Clinical assessment of urinary prostate cancer antigen 3 in Chinese population: a large-scale, prospective and multicenter study
Abstract Background To assess the clinical utility of PCA3 in the diagnostic accuracy, the correlation between PCA3 and biopsy or pathological characteristics and the performance of PCA3 to reduce the unnecessary biopsies in Chinese population. Methods A prospective study including patients with ind...
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BMC
2024-12-01
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| Series: | World Journal of Surgical Oncology |
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| Online Access: | https://doi.org/10.1186/s12957-024-03643-8 |
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| author | Xuan Shu Jiaming Wang Wen Cai Shen Lin Jiangfeng Li Xueyou Ma Yufan Ying Yat Sai Terry Wang Xiao Wang Hong Chen Chunyu Jin Ben Liu Liping Xie Jindan Luo |
| author_facet | Xuan Shu Jiaming Wang Wen Cai Shen Lin Jiangfeng Li Xueyou Ma Yufan Ying Yat Sai Terry Wang Xiao Wang Hong Chen Chunyu Jin Ben Liu Liping Xie Jindan Luo |
| author_sort | Xuan Shu |
| collection | DOAJ |
| description | Abstract Background To assess the clinical utility of PCA3 in the diagnostic accuracy, the correlation between PCA3 and biopsy or pathological characteristics and the performance of PCA3 to reduce the unnecessary biopsies in Chinese population. Methods A prospective study including patients with indication of prostate biopsies from 4 centers was conducted. All patients underwent PCA3 urine tests and prostate biopsies. The PCA3 score was analyzed by PCA3 gene expression Detection Kit (Fluorescent RT-PCR) (York biotech, Cat.#YDM-B01, China). Base model (clinical information) and PCA3 model (PCA3 scores and clinical information) were constructed via multivariate logistic regression. Discrimination, calibration and decision curve analysis were evaluated. Results In 1117 patients, 587 men with positive biopsy results had higher median PCA3 scores than those with negative biopsy results (p < 0.001). PCA3 scores had a greater area under the curve (AUC) than tPSA, %fPSA and PSAD in all PSA levels or PSA gray zone (4–10 ng/ml). Men with biopsy Gleason score < 7 had lower median PCA3 scores than those with Gleason score ≥ 7 (p = 0.016). In radical prostatectomy specimens, PCA3 scores were significantly associated with high-grade PCa (p = 0.002) and EAU biochemical recurrence risk (p = 0.044), but not extracapsular extension (p = 0.072), seminal vesicle invasion (p = 0.482) and T stage (p = 0.457). Regression analysis showed that the AUC increased from 0.806 (base model) to 0.873 (PCA3 model). PCA3 model with cutoff 0.15 could reduce 35.3% prostate biopsies and delay 5.8% high-grade PCa. Conclusions PCA3 had a better diagnosis accuracy than tPSA, %fPSA and PSAD. PCA3 was a significantly independent predictor for risk stratification, suggesting that PCA3 could provide incremental value to reduce unnecessary prostate biopsies. |
| format | Article |
| id | doaj-art-c970dd0de640425cbb2a55f7b5679f40 |
| institution | Kabale University |
| issn | 1477-7819 |
| language | English |
| publishDate | 2024-12-01 |
| publisher | BMC |
| record_format | Article |
| series | World Journal of Surgical Oncology |
| spelling | doaj-art-c970dd0de640425cbb2a55f7b5679f402025-01-05T12:32:10ZengBMCWorld Journal of Surgical Oncology1477-78192024-12-0122111010.1186/s12957-024-03643-8Clinical assessment of urinary prostate cancer antigen 3 in Chinese population: a large-scale, prospective and multicenter studyXuan Shu0Jiaming Wang1Wen Cai2Shen Lin3Jiangfeng Li4Xueyou Ma5Yufan Ying6Yat Sai Terry Wang7Xiao Wang8Hong Chen9Chunyu Jin10Ben Liu11Liping Xie12Jindan Luo13Department of Urology, The First Affiliated Hospital, Zhejiang University School of MedicineDepartment of Urology, The First Affiliated Hospital, Zhejiang University School of MedicineDepartment of Urology, Second Affiliated Hospital, Zhejiang University School of MedicineDepartment of Urology, the Fourth Affiliated Hospital of School of Medicine, and International School of Medicine, International Institutes of Medicine, Zhejiang UniversityDepartment of Urology, The First Affiliated Hospital, Zhejiang University School of MedicineDepartment of Urology, The First Affiliated Hospital, Zhejiang University School of MedicineDepartment of Urology, The First Affiliated Hospital, Zhejiang University School of MedicineLord Byng Secondary School BCDepartment of Urology, The First Affiliated Hospital, Zhejiang University School of MedicineDepartment of Urology, The First Affiliated Hospital, Zhejiang University School of MedicineYork Biotechnology Co., LtdDepartment of Urology, The First Affiliated Hospital, Zhejiang University School of MedicineDepartment of Urology, The First Affiliated Hospital, Zhejiang University School of MedicineDepartment of Urology, The First Affiliated Hospital, Zhejiang University School of MedicineAbstract Background To assess the clinical utility of PCA3 in the diagnostic accuracy, the correlation between PCA3 and biopsy or pathological characteristics and the performance of PCA3 to reduce the unnecessary biopsies in Chinese population. Methods A prospective study including patients with indication of prostate biopsies from 4 centers was conducted. All patients underwent PCA3 urine tests and prostate biopsies. The PCA3 score was analyzed by PCA3 gene expression Detection Kit (Fluorescent RT-PCR) (York biotech, Cat.#YDM-B01, China). Base model (clinical information) and PCA3 model (PCA3 scores and clinical information) were constructed via multivariate logistic regression. Discrimination, calibration and decision curve analysis were evaluated. Results In 1117 patients, 587 men with positive biopsy results had higher median PCA3 scores than those with negative biopsy results (p < 0.001). PCA3 scores had a greater area under the curve (AUC) than tPSA, %fPSA and PSAD in all PSA levels or PSA gray zone (4–10 ng/ml). Men with biopsy Gleason score < 7 had lower median PCA3 scores than those with Gleason score ≥ 7 (p = 0.016). In radical prostatectomy specimens, PCA3 scores were significantly associated with high-grade PCa (p = 0.002) and EAU biochemical recurrence risk (p = 0.044), but not extracapsular extension (p = 0.072), seminal vesicle invasion (p = 0.482) and T stage (p = 0.457). Regression analysis showed that the AUC increased from 0.806 (base model) to 0.873 (PCA3 model). PCA3 model with cutoff 0.15 could reduce 35.3% prostate biopsies and delay 5.8% high-grade PCa. Conclusions PCA3 had a better diagnosis accuracy than tPSA, %fPSA and PSAD. PCA3 was a significantly independent predictor for risk stratification, suggesting that PCA3 could provide incremental value to reduce unnecessary prostate biopsies.https://doi.org/10.1186/s12957-024-03643-8PCA3Prostate cancerRisk stratification |
| spellingShingle | Xuan Shu Jiaming Wang Wen Cai Shen Lin Jiangfeng Li Xueyou Ma Yufan Ying Yat Sai Terry Wang Xiao Wang Hong Chen Chunyu Jin Ben Liu Liping Xie Jindan Luo Clinical assessment of urinary prostate cancer antigen 3 in Chinese population: a large-scale, prospective and multicenter study World Journal of Surgical Oncology PCA3 Prostate cancer Risk stratification |
| title | Clinical assessment of urinary prostate cancer antigen 3 in Chinese population: a large-scale, prospective and multicenter study |
| title_full | Clinical assessment of urinary prostate cancer antigen 3 in Chinese population: a large-scale, prospective and multicenter study |
| title_fullStr | Clinical assessment of urinary prostate cancer antigen 3 in Chinese population: a large-scale, prospective and multicenter study |
| title_full_unstemmed | Clinical assessment of urinary prostate cancer antigen 3 in Chinese population: a large-scale, prospective and multicenter study |
| title_short | Clinical assessment of urinary prostate cancer antigen 3 in Chinese population: a large-scale, prospective and multicenter study |
| title_sort | clinical assessment of urinary prostate cancer antigen 3 in chinese population a large scale prospective and multicenter study |
| topic | PCA3 Prostate cancer Risk stratification |
| url | https://doi.org/10.1186/s12957-024-03643-8 |
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