Age-specific PCA3 score reference values for diagnosis of prostate cancer

Klatte, Tobias; Waldert, Matthias; Martino, Michela de; Schatzl, Georg; Mannhalter, Christine; Remzi, Mesut

doi:10.1007/s00345-011-0749-1

Cited by 16 publications

(7 citation statements)

References 29 publications

(44 reference statements)

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“…We also found no significant correlations between urine PCA3 or TMPSS2:ERG scores with IPSS score, PSA doubling time, or the use of statins, diabetes medications, 5 α-reductase inhibitors, or NSAIDs (data not shown). TMPRSS2:ERG score was not correlated with age, but PCA3 levels were positively correlated with advancing age ( P < 0.0001), as has been observed by others (38). …”

Section: Resultssupporting

confidence: 82%

Urinary TMPRSS2:ERG and PCA3 in an Active Surveillance Cohort: Results from a Baseline Analysis in the Canary Prostate Active Surveillance Study

Lin

Newcomb

Brown

et al. 2013

Clinical Cancer Research

129

102

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Purpose Active surveillance is used to manage low risk prostate cancer. Both PCA3 and TMRPSS2-ERG are promising biomarkers that may be associated with aggressive disease. This study examines the correlation of these biomarkers with higher cancer volume and grade determined at the time of biopsy in an active surveillance cohort. Experimental Design Post-DRE urine was collected prospectively as part of the multi-institutional Canary Prostate Active Surveillance Study (PASS). PCA3 and TMPRSS2-ERG levels were analyzed in urine collected at study entry. Biomarker scores were correlated to clinical and pathologic variables. Results In 387 men, both PCA3 and TMPRSS2-ERG scores were significantly associated with higher volume disease. For a negative repeat biopsy, and 1–10%, 11–33%, ≥34% positive cores, median PCA3 and TMPRSS2-ERG scores increased incrementally (P < 0.005). Both PCA3 and TMPRSS2-ERG scores were also significantly associated with presence of high grade disease. For a negative repeat biopsy, Gleason 6 and Gleason ≥7 cancers, the median PCA3 and TMPRSS2-ERG scores also increased incrementally (P = 0.02 and P = 0.001, respectively). Using the marker scores as a continuous variables, the odds ratio for a biopsy in which cancer was detected versus a negative repeat biopsy (ref) on modeling was 1.41 (95% CI 1.07–1.85), P = 0.01 for PCA3 and 1.28 (95% CI 1.10–1.49), P = 0.001 for TMPRSS2-ERG. Conclusions For men on active surveillance both PCA3 and TMPRSS2-ERG appear to stratify risk of having aggressive cancer as defined by tumor volume or Gleason score.

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Section: Resultssupporting

confidence: 82%

Urinary TMPRSS2:ERG and PCA3 in an Active Surveillance Cohort: Results from a Baseline Analysis in the Canary Prostate Active Surveillance Study

Lin

Newcomb

Brown

et al. 2013

Clinical Cancer Research

129

102

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“…Furthermore, these relationships are generally explored in at-risk populations referred for prostate biopsy, in which the presence or absence of cancer strongly drives observations, potentially confounding the true relationship between biomarkers and noncancer factors. Klatte et al [25] previously assessed the association of PCA3 with age among 205 men referred for 14-core biopsy because of PSA >3.0 ng/ml or suspicious DRE. On biopsy, 76 men (37%) had cancer.…”

Section: Discussionmentioning

confidence: 99%

Association of Urinary MyProstateScore, Age, and Prostate Volume in a Longitudinal Cohort of Healthy Men: Long-term Findings from the Olmsted County Study

Tosoian

Dunn

Niknafs

et al. 2021

European Urology Open Science

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Background Serum prostate-specific antigen (PSA), used in prostate cancer screening, is nonspecific for cancer and is affected by age and prostate volume. More specific biomarkers could be more accurate for early detection of prostate cancer and reduce unnecessary prostate biopsies. Objective To evaluate the association of age and prostate volume with urinary MyProstateScore (MPS) in a screened, longitudinal cohort without evidence of prostate cancer. Design, setting, and participants The Olmsted County Study included men aged 40–79 yr who underwent biennial prostate cancer screening. PSA ≥4.0 ng/ml or abnormal rectal examination triggered prostate biopsy, and patients with cancer were excluded. The remaining men submitted urinary specimens for PCA3 and TMPRSS2:ERG testing. Outcome measurements and statistical analysis MPS was calculated using the validated, locked model for grade group ≥2 cancer that includes serum PSA, urinary PCA3, and urinary TMPRSS2:ERG. The associations of age and volume with biomarkers were assessed in multivariable regression models. The t statistic was used to quantify the strength of associations independent of the unit of measurement, and R 2 values were used to estimate the proportion of biomarker variance explained by each factor. Results and limitations The study included 314 screened men without evidence of cancer. In multivariable models including age and volume, PCA3 score was significantly associated with age ( t = 7.51; p < 0.001), while T2:ERG score was not associated with age or volume. MPS was significantly associated with both age ( t = 7.45; p < 0.001) and volume ( t = 3.56; p < 0.001), but accounting for age alone explained the variability observed ( R 2 = 0.29) in a similar way to the model including age and volume ( R 2 = 0.31). The variability of PCA3, T2:ERG, and MPS was less dependent on age and volume than the variability for PSA ( R 2 = 0.45). Conclusions In a cohort of longitudinally screened men without evidence of cancer, we found that MPS demonstrated less variability with noncancer factors (age, prostate volume) than PSA did. These findings support the biology of these markers as more cancer-specific than PSA and highlight their promise in reducing the morbidity associated with PSA-based screening. Patient summary In a group of men with no evidence of prostate cancer, we found that each of three urine-based markers of cancer—PCA3, T2:ERG, and the commercially available MyProstateScore test—showed less variability with noncan...

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“…Group comparison analysis was performed using nonparametric Wilcoxon Kruskal-Wallis tests with post hoc analyses idem for the categorized variables. A multivariate logistic regression model with age and Gleason score as confounding variables [4,10] was constructed. In the group of patients with negative biopsy results, the PCA3 score was compared to the inflammation scores.…”

Section: Methodsmentioning

confidence: 99%

“…Hennenlotter For example, prostate inflammation may alter the test quality or accuracy as the samples used consist of expressed urine following standardized digital rectal manipulation. Previous analyses have shown that patient age affects the result [4].…”

Section: Introductionmentioning

confidence: 97%

Impact of Histopathological Prostate Inflammation on Urine-Based Prostate Cancer Prediction Using the Prostate Cancer Gene 3 Score

et al. 2020

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Introduction: The Prostate Cancer gene 3 (PCA3) urine test has gained importance in the diagnostic workup of prostate cancer (PC). Limited evidence suggests that PCA3 is not altered in the presence of inflammation. Objective: To assess the impact of histological inflammation on PCA3. Methods: PCA3 was evaluated in patients prior to prostate biopsy (n = 193) and to radical prostatectomy (n = 197). In patients without PC, inflammation was assessed and quantified by individual scores integrating grade and extent. Uni-and multivariate analyses were performed to assess the impact of inflammation grade on PCA3. Results: The PCA3 scores prior to prostatectomy were lower (median 45) than those before positive biopsy (57; p = 0.008). Of 101 negative biopsies, 78% showed inflammation. The median PCA3 scores in the groups with no inflammation and with maximum grade 1 (n = 22), 2 (n = 38), and 3 (n = 19) inflammation were 45, 38, 27, and 25 (p = 0.016). The multivariate models revealed a decrease in PCA3 proportional to the grade and extent of inflammation (p < 0.04 each). Conclusions: The present data imply that the PCA3 score decreases in the presence of inflammation, which is relevant, for instance, to testing after a recently performed biopsy. In general, inflammation should be regarded as a factor putatively influencing PCA3 and other available and upcoming PC tests.

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Age-specific PCA3 score reference values for diagnosis of prostate cancer

Abstract: PCA3 score increases with age, independent of PCa presence. Age-specific PCA3 score reference values are superior to PSA, continuous PCA3 score, and PCA3-35 in predicting initial pBx outcome. Therefore, an age-adjusted PCA3 score should be used for interpretation of the results.

Cited by 16 publications

References 29 publications

Urinary TMPRSS2:ERG and PCA3 in an Active Surveillance Cohort: Results from a Baseline Analysis in the Canary Prostate Active Surveillance Study

Urinary TMPRSS2:ERG and PCA3 in an Active Surveillance Cohort: Results from a Baseline Analysis in the Canary Prostate Active Surveillance Study

Association of Urinary MyProstateScore, Age, and Prostate Volume in a Longitudinal Cohort of Healthy Men: Long-term Findings from the Olmsted County Study

Impact of Histopathological Prostate Inflammation on Urine-Based Prostate Cancer Prediction Using the Prostate Cancer Gene 3 Score

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