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Diagnostic value of urine prostate cancer antigen 3 test using a cutoff value of 35 μg/L in patients with prostate cancer

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Tumor Biology

Abstract

The aim of this study is to explore the diagnostic role of urine prostate cancer antigen 3 (PCA3) in detecting prostate cancer (PCa) through a systematic review and meta-analysis. Relevant research studies aiming at the application of urine PCA3 level in PCa diagnosis were searched in PubMed, Embase, Chinese Biomedical Database (CBM), Chinese National Knowledge Infrastructure (CNKI), VIP, and Wan Fang databases independently, which were published up to May 8, 2014. The pooled sensitivity, specificity, positive diagnostic likelihood ratio (DLR+), negative diagnostic likelihood ratio (DLR−), diagnostic odds ratio, and the area under the summary receiver operating characteristic were used to evaluate the value of urine PCA3 in diagnosis of PCa by using the Meta-DiSc and STATA 12.0 statistical software. Sixteen research studies with a total 2,457 PCa patients and 4,236 control individuals were included in this meta-analysis. Overall, the results showed sensitivity and specificity of urine PCA3 in the diagnosis of PCa was 0.57 (95 % CI = 0.55–0.59), and 0.71 (95 % CI = 0.70–0.73), respectively. The DLR + and PLR − in the diagnosis of PCa were 2.12 (95 % CI = 1.89–2.38), and 0.55 (95 % CI = 0. 50–0.61), respectively. The pooled diagnostic odds ratio was 3.93 (95 % CI = 3.28–4.72). The area under the curve (AUCs) and *Q index estimate were 0.7118 and 0.6623, respectively. Urine PCA3 is a potential biomarker for the diagnosis of PCa. However, further well-designed studies with large samples will be needed to confirm the results got from present meta-analysis.

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Reference

  1. Siegel R, Naishadham D, Jemal A. Cancer statistics, 2013. CA Cancer J Clin. 2013;63(1):11–30.

    Article  PubMed  Google Scholar 

  2. Jemal A, Bray F, Center MM, Ferlay J, Ward E, Forman D. Global cancer statistics. CA Cancer J Clin. 2011;61(2):69–90.

    Article  PubMed  Google Scholar 

  3. Boyle P, Ferlay J. Cancer incidence and mortality in Europe, 2004. Ann Oncol. 2005;16:481–8.

    Article  CAS  PubMed  Google Scholar 

  4. Freedland SJ, Partin AW. Detecting prostate cancer with molecular markers: uPM3. Rev Urol. 2005;7:236–8.

    PubMed Central  PubMed  Google Scholar 

  5. Groskopf J, Aubin SM, Deras IL, Blase A, Bodrug S, Clark C, et al. APTIMA PCA3 molecular urine test: development of a method to aid in the diagnosis of prostate cancer. Clin Chem. 2006;52:1089–95.

    Article  CAS  PubMed  Google Scholar 

  6. Overmyer M. New PCA assay aids critical diagnostic decisions. Urology Times. July 1, 2006.

  7. Marks LS, Fradet Y, Lim Deras I, Blase A, Mathis J, Aubin SM, et al. PCA3 molecular urine assay for prostate cancer in men undergoing repeat biopsy. Urology. 2007;69:532–5.

    Article  PubMed  Google Scholar 

  8. Heidenreich A, Bellmunt J, Bolla M, Joniau S, Mason M, Matveev V, et al. EAU guidelines on prostate cancer. Part 1: screening, diagnosis, and treatment of clinically localised disease. Eur Urol. 2011;59:61–71.

    Article  PubMed  Google Scholar 

  9. Jemal A, Bray F, Center MM, Ferlay J, Ward E, Forman D. Global cancer statistics. CA Cancer J Clin. 2011;61:69–90.

    Article  PubMed  Google Scholar 

  10. Center MM, Jemal A, Lortet-Tieulent J, Ward E, Ferlay J, Brawley O, et al. International variation in prostate cancer incidence and mortality rates. Eur Urol. 2012;61:1079–92.

    Article  PubMed  Google Scholar 

  11. Whiting P, Rutjes AWS, Reitsma JB, Bossuyt PMM, Kleijnen J. The development of QUADAS: a tool for the quality assessment of studies of diagnostic accuracy included in systematic reviews. BMC Med Res Methodol. 2003;10:3–25.

    Google Scholar 

  12. Glas AS, Lijmer JG, Prins MH, Bonsel GJ, Bossuyt PMM. The diagnostic odds ratio: a single indicator of test performance. J Clin Epidemiol. 2003;56:1129–35.

    Article  PubMed  Google Scholar 

  13. Higgins JPT, Thompson SG, Deeks JJ, Altman DG. Measuring inconsistency in meta-analyses. Br Med J. 2003;327(7414):557–60.

    Article  Google Scholar 

  14. Walter SD. Properties of the summary receiver operating characteristic (SROC) curve for diagnostic test data. Stat Med. 2002;21(9):1237–56.

    Article  CAS  PubMed  Google Scholar 

  15. Zamora J, Abraira V, Muriel A, et al. Meta-DiSc: a software for meta-analysis of test accuracy data. BMC Med Res Methodol. 2006;6:31.

    Article  PubMed Central  PubMed  Google Scholar 

  16. Haese A, de la Taille A, van Poppel H, Marberger M, Stenzl A, Mulders PFA, et al. Clinical utility of the PCA3 urine assay in European men scheduled for repeat biopsy. Eur Urol. 2008;54:1081–8.

    Article  PubMed  Google Scholar 

  17. Deras IL, Aubin SMJ, Blase A, Day JR, Koo S, Partin AW, et al. PCA3: a molecular urine assay for predicting prostate biopsy outcome. J Urol. 2008;179:1587–92.

    Article  PubMed  Google Scholar 

  18. Nakanishi H, Groskopf J, Fritsche HA, Bhadkamkar V, Blase A, Kumar SV, et al. PCA3 molecular urine assay correlates with prostate cancer tumor volume: implication in selecting candidates for active surveillance. J Urol. 2008;179:1804–9.

    Article  PubMed  Google Scholar 

  19. Shappell SB, Fulmer J, Arguello D, Wright BS, Oppenheimer JR, Putzi MJ. PCA3 Urine mRNA testing for prostate carcinoma: patterns of use by community urologists and assay performance in reference laboratory setting. Urology. 2009;73:363–8.

    Article  PubMed  Google Scholar 

  20. Wang R, Chinnaiyan AM, Dunn RL, Wojno KJ, Wei JT. Rational approach to implementation of prostate cancer antigen 3 into clinical care. Cancer. 2009;115:3879–86.

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  21. Roobol MJ, Schroder FH, van Leeuwen P, Wolters T, van den Bergh RC, van Leenders GJ, et al. Performance of the prostate cancer antigen 3 (PCA3) gene and prostate-specific antigen in prescreened men: exploring the value of PCA3 for a first-line diagnostic test. Eur Urol. 2010;58:475–81.

    Article  CAS  PubMed  Google Scholar 

  22. Rigau M, Morote J, Mir MC, Ballesteros C, Ortega I, Sanchez A, et al. PSGR and PCA3 as biomarkers for the detection of prostate cancer in urine. Prostate. 2010;70:1760–7.

    PubMed  Google Scholar 

  23. Auprich M, Haese A, Walz J, Pummer K, De La Taille A, Graefen M, et al. External validation of urinary PCA3-based nomograms to individually predict prostate biopsy outcome. Eur Urol. 2010;58:727–32.

    Article  PubMed  Google Scholar 

  24. Vlaeminck-Guillem V, Campos-Fernandes JL, Champetier D, Chikh K, Decaussin-Petrucci M, Devonec M, et al. Value of PCA3 urinary test for prostate biopsy decision: the Lyon-Sud University Hospital experience. Ann Biol Clin (Paris). 2011;69:31–9.

    Google Scholar 

  25. Ochiai A, Okihara K, Kamoi K, Iwata T, Kawauchi A, Miki T, et al. Prostate cancer gene 3 urine assay for prostate cancer in Japanese men undergoing prostate biopsy. Int J Urol. 2011;18(3):200–5.

    Article  CAS  PubMed  Google Scholar 

  26. De La Taille A, Irani J, Graefen M, Chun F, De Reijke T, Kil P, et al. Clinical evaluation of the PCA3 assay in guiding initial biopsy decisions. J Urol. 2011;185:2119–25.

    Article  PubMed  Google Scholar 

  27. Ng CF, Chiu PKF, Lam NY, Yeung R, Chow J, Chan B. The role of urine prostate cancer antigen 3 mrna levels in the diagnosis of prostate cancer among Hong Kong Chinese patients. Hong Kong Med J. 2012;18:459–65.

    CAS  PubMed  Google Scholar 

  28. Crawford ED, Rove KO, Trabulsi EJ, Qian JQ, Drewnowska KP, Kaminetsky JC, et al. Diagnostic performance of PCA3 to detect prostate cancer in men with increased prostate specific antigen: a prospective study of 1,962 cases. J Urol. 2012;188:1726–31.

    Article  PubMed  Google Scholar 

  29. Salagierski M, Mulders P, Schalken JA. Predicting prostate biopsy outcome using a PCA3-based nomogram in a Polish cohort. Anticancer Res. 2013;33:553–8.

    PubMed  Google Scholar 

  30. Ochiai A, Okihara K, Kamoi K, Oikawa T, Shimazui T, Murayama SI, et al. Clinical utility of the prostate cancer gene 3 (PCA3) urine assay in Japanese men undergoing prostate biopsy. BJU Int. 2013;111:928–33.

    Article  CAS  PubMed  Google Scholar 

  31. Jemal A, Siegel R, Xu J, et al. Cancer statistics, 2010. CA Cancer J Clin. 2010;60(5):277–300.

    Article  PubMed  Google Scholar 

  32. Garnick MB. Prostate cancer: screening, diagnosis, and management. Ann Intern Med. 1993;118:804–18.

    Article  CAS  PubMed  Google Scholar 

  33. Dall'Era MA, Cooperberg MR, Chan JM, et al. Active surveillance for early-stage prostate cancer: review of the current literature. Cancer. 2008;112:1650–9.

    Article  PubMed  Google Scholar 

  34. Schroder FH, Hugosson J, Roobol MJ, et al. Screening and prostate-cancer mortality in a randomized European study. N Engl J Med. 2009;360:11320–8.

    Article  Google Scholar 

  35. Thompson IM, Pauler DK, Goodman PJ, et al. Prevalence of prostate cancer among men with a prostate-specific antigen level < or =4.0 ng per milliliter. N Engl J Med. 2004;350(22):2239–46.

    Article  CAS  PubMed  Google Scholar 

  36. Lacetera V, Galosi AB, Cantoro U, et al. Transrectal ultrasound (TRUS) and TRUS-biopsy accuracy in potential candidates for PRIAS active surveillance protocol. Arch Ital Urol Androl. 2012;84:272–5.

    PubMed  Google Scholar 

  37. Barbera M, Pepe P, Paola Q, Aragona F. PCA3 score accuracy in diagnosing prostate cancer at repeat biopsy: our experience in 177 patients. Arch Ital Urol Androl. 2012;84:227–9.

    PubMed  Google Scholar 

  38. Deras IL, Aubin SM, Blase A, et al. PCA3: a molecular urine assay for predicting prostate biopsy outcome. J Urol. 2008;179:1587–92.

    Article  PubMed  Google Scholar 

  39. Goode RR, Marshall SJ, Duff M, Chevli E, Chevli KK. Use of PCA3 in detecting prostate cancer in initial and repeat prostate biopsy patients. Prostate. 2013;73:48–53.

    Article  CAS  PubMed  Google Scholar 

  40. de la Taille A, Irani J, Graefen M, et al. Clinical evaluation of the PCA3 assay in guiding initial biopsy decisions. J Urol. 2011;185:2119–25.

    Article  PubMed  Google Scholar 

  41. Swets JA. ROC analysis applied to the evaluation of medical imaging techniques. Invest Radio. 1979;14(2):109–21.

    Article  CAS  Google Scholar 

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Acknowledgments

This work was supported by the Liaoning Social Development project of China (grant no. 2013225220).

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Authors and Affiliations

  1. Department of Urology, Liaoning Province Tumor Hospital, Shenyang, 110042, China

    Bin Hu

  2. Department of Oncology, Liaoning Province Tumor Hospital, Shenyang, 110042, China

    Hongmei Yang

  3. Department of Urinary Surgery, General Hospital of Shenyang Military Area Command, Shenyang, 110016, China

    Hongwei Yang

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  1. Bin Hu
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  2. Hongmei Yang
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  3. Hongwei Yang
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Correspondence to Hongwei Yang.

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Hu, B., Yang, H. & Yang, H. Diagnostic value of urine prostate cancer antigen 3 test using a cutoff value of 35 μg/L in patients with prostate cancer. Tumor Biol. 35, 8573–8580 (2014). https://doi.org/10.1007/s13277-014-2109-4

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