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PCA3 gene test in the diagnostics and surveillance of prostate cancer
Julkaistu 07.05.2010 00.01

Background
Serum PSA is widely used in the diagnostics and surveillance of prostate cancer, although its non-specificity to prostate cancer limits its usefulness. The prostate cancer gene 3 (PCA3) has been proposed as a novel marker of prostate cancer. Aim The aim of this systematic literature review was to assess the sensitivity and specificity of the commercially available PCA3 test in indicating prostate cancer as compared to a pathological examination of biopsy specimens. In addition, we assessed the correlation of the PCA3 test to the characteristics of the prostate tumours and whether the number of prostate biopsies could be reduced by using the test.

Methods
The Medline, Cochrane and Journals@Ovid databases were searched for relevant studies.

Results
144 research articles and reviews were found. Six original research articles published between 2006 and 2008 fulfilled the inclusion criteria. They reported PCA3 results either from prostate biopsies or before radical prostatectomy. The AUC values of the PCA3 test for predicting a positive biopsy finding were 0.66−0.78. PCA3 correlated with the size and extracapsular growth of the tumour. There were no studies reporting patient follow-up after a biopsy or prostatectomy.

Conclusions
There is so far scarce evidence on the benefits of the PCA3-test. PCA3 as such is probably not an adequately sensitive indicator of prostate cancer. When combined with other diagnostic methods the PCA3 test may, however, provide some additional information in the evaluation of the probability and aggressiveness of prostate cancer.

Kimmo Taari, Kristina Hotakainen, Maija Saijonkari, Riitta Grahn

Jaana Leipälä, Senior Medical Officer, Adjunct Professor, National Institute for Health and Welfare (THL), E-mail: jaana.leipala@thl.fi

Linguistic revision: Mark Phillips, THL

Finnish Medical Journal 2010;65:1623–9.

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