PCA3 and PCA3-Based Nomograms Improve Diagnostic Accuracy in Patients Undergoing First Prostate Biopsy

International Journal of Molecular Sciences

Alain Ruffion¹  Marian Devonec¹  Denis Champetier¹  Myriam Decaussin-Petrucci²  Claire Rodriguez-Lafrasse²  Philippe Paparel¹  Paul Perrin¹ 

[1] Department of Urology, University Hospital of Lyon Sud, Hospices Civils of Lyon, Pierre Bénite 69495, France; E-Mails:;Medical Faculty of Lyon 1 University, Lyon 69000, France; E-Mails:

关键词: urine biomarker;    nomogram;    initial prostate biopsy;    prostate cancer;    prostate cancer antigen 3;   

DOI  :  10.3390/ijms140917767

来源: mdpi

【 摘 要 】

While now recognized as an aid to predict repeat prostate biopsy outcome, the urinary PCA3 (prostate cancer gene 3) test has also been recently advocated to predict initial biopsy results. The objective is to evaluate the performance of the PCA3 test in predicting results of initial prostate biopsies and to determine whether its incorporation into specific nomograms reinforces its diagnostic value. A prospective study included 601 consecutive patients addressed for initial prostate biopsy. The PCA3 test was performed before ≥12-core initial prostate biopsy, along with standard risk factor assessment. Diagnostic performance of the PCA3 test was evaluated. The three available nomograms (Hansen’s and Chun’s nomograms, as well as the updated Prostate Cancer Prevention Trial risk calculator; PCPT) were applied to the cohort, and their predictive accuracies were assessed in terms of biopsy outcome: the presence of any prostate cancer (PCa) and high-grade prostate cancer (HGPCa). The PCA3 score provided significant predictive accuracy. While the PCPT risk calculator appeared less accurate; both Chun’s and Hansen’s nomograms provided good calibration and high net benefit on decision curve analyses. When applying nomogram-derived PCa probability thresholds ≤30%, ≤6% of HGPCa would have been missed, while avoiding up to 48% of unnecessary biopsies. The urinary PCA3 test and PCA3-incorporating nomograms can be considered as reliable tools to aid in the initial biopsy decision.

【 授权许可】

CC BY   
© 2013 by the authors; licensee MDPI, Basel, Switzerland