PCA3 score of 20 could improve prostate cancer detection: Results obtained on 734 Italian individuals

Background: The role of PCa3 score in the diagnostics of prostate cancer (PCa) is still under debate, mainly due to the lack of a univocal cut-off useful alone or within nomograms proposed by Urologists. Aim of present study is to compare different PCA3 score cut-off values (20, 25, 35 and 50) observed in 734 patients with suspected PCa who were monitored for about three years with single or multiple biopsies. Methods: 734 patients who underwent first prostate biopsy for suspected PCa were enrolled. One month later the first biopsy result was obtained, both negative and positive PCa patients were investigated by means of PCA3 score, in order to establish risk of PCa presence on repeated biopsies. Results: PCA3 score was significantly higher (p < 0.001) in PCa patients to the PCa negative ones, while tPSA did not significantly vary. The best negative predictive value (NPV 97.5\%) and sensitivity (95.4\%) result were obtained when a PCA3 score of 20 was used. At cut-off value of 50, the 75\% of patients resulted as false positive. Conclusions: PCA3 score of 20 could be safely introduced in the prostate cancer screening diagnostic flow chart, since it provides important information regarding the outcome of re-biopsy. (C) 2013 Elsevier B.V. All rights reserved.