Real-time PCR PCA3 assay is a useful test measured in urine to improve prostate cancer detection

•Probability of prostate cancer is related to PCA3 score.•RT-qPCR assay is an easy and cheap test with potential use in the detection of prostate cancer.•PCA3 score could improve the prediction of PCa and help in selecting better men for biopsy.

BackgroundThe usefulness of PCA3 in the management of early prostate cancer (PCa) is on debate. The aim of this study was to evaluate PCA3 in the detection of PCa and its relationship with tumor aggressiveness.Methods and patientsPCA3 score was measured by real time PCR in urinary sediments of 122 patients who underwent prostate biopsy for PSA > 4 μg/L.ResultsAnalysis of ROC curves showed an area under the curve (AUC) of 0.804 for PCA3 score, while the AUCs were 0.587 and 0.697 for PSA and % free PSA, respectively. The probability of positive biopsy increased in relation to PCA3 score, with variations from 37% to 96% for patients with PCA3 score lower than 0.90 or higher than 1.04, respectively. We chose the cut-off value of 0.90, corresponding to a sensitivity of 92.5%, for which we obtained a specificity of 41.5%. No significant differences in PCA3 score were found in relation to Gleason score or clinical stage.ConclusionsThe results show a high probability of PCa in patients with an elevated PCA3 score, although we did not find any relationship with aggressiveness of the tumor. PCA3 score can help to select more precisely which patients will need to perform a biopsy of the prostate.