PCA3 score and prostate cancer diagnosis at repeated saturation biopsy. Which cut-off: 20 or 35?
Int. braz. j. urol
;
38(4): 489-495, July-Aug. 2012. ilus, tab
Artigo
em Inglês
| LILACS
| ID: lil-649442
ABSTRACT
PURPOSE:
To compare PCA3 score cut-off of 35 vs 20 in PCa diagnosis in patients undergoing repeated saturation prostate biopsy (SPBx). MATERIALS ANDMETHODS:
From January 2010 to May 2011, 118 patients (median 62.5 years) with primary negative extended biopsy underwent a transperineal SPBx (median 30 cores) for persistent suspicion of PCa. The indications for repeated biopsy were persistently high or increasing PSA values; PSA > 10 ng/mL, PSA values between 4.1-10 or 2.6-4 ng/mL with free/total PSA ≤ 25% and ≤ 20%, respectively; moreover, before performing SPBx urinary PCA3 score was evaluated.RESULTS:
All patients had negative DRE and median PSA was 8.5 ng/mL (range 3.7-24 ng/mL). A T1c PCa was found in 32 patients (27.1%) PCA3 score was 59 (median; range 7-201) in the presence of PCa and 35 (median; range 3-253) in the absence of cancer (p < 0.05). In the presence of ASAP and HGPIN median PCA3 score was 109 (range 42-253) and 40 (range 30-140), respectively. Diagnostic accuracy, sensitivity, specificity, PPV and NPV of PCA3 score cut-off of 20 vs 35 in PCa diagnosis were 44.9 vs 50%, 90.6 vs 71.9%, 27.9 vs 41.8%, 31.9 vs 31.5% and 88.9 vs 80%, respectively. ROC analysis demonstrated an AUC for PCA3 ≥ 20 vs ≥ 35 of 0.678 and 0.634, respectively.CONCLUSIONS:
Our data suggest that PCA3 is more useful as an exclusion tool; moreover, setting a PCA3 cut-off at 20 vs 35, would have avoided 22.9 vs 38.1% of biopsies while missing 9.4% and 28% diagnosis of PCa.
Texto completo:
DisponíveL
Índice:
LILACS (Américas)
Assunto principal:
Próstata
/
Neoplasias da Próstata
/
Antígeno Prostático Específico
/
Antígenos de Neoplasias
Tipo de estudo:
Estudo diagnóstico
Limite:
Idoso
/
Humanos
/
Masculino
Idioma:
Inglês
Revista:
Int. braz. j. urol
Assunto da revista:
Urologia
Ano de publicação:
2012
Tipo de documento:
Artigo
País de afiliação:
Itália
Instituição/País de afiliação:
University of Catania/IT
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