PCA3

from Wikipedia, the free encyclopedia
nucleic acid
General
Surname PCA3
other names

DD3, NCRNA00019, PCAT3, prostate cancer associated 3 (non-protein coding), prostate cancer associated 3, PRUNE2-AS1

Identifiers
Entrez

50652

GeneCards

PCA3

properties
Taxon

homo sapiens

PCA3 ( prostate cancer antigen 3 ) describes a non-coding ribonucleic acid that serves as a biomarker for prostate cancer . Detection methods for this molecule were developed for medical diagnostics and are commercially available. The so-called "PCA3 test" is used to detect PCA3-positive tumor cells in the urine .

PCA3 test

Prostate cancer is the most common cancer diagnosed in men in Germany. During the search for diagnostic methods for prostate cancer, a molecule (a so-called "non-coding RNA ") was discovered which is present in cancer cells of the prostate in almost 100 times higher concentration than in normal prostate cells.

After a medical examination of the prostate by touch, prostate cells, including any cancer cells that may be present, are released into the urine, where they can then be detected. This is gentler on the person affected than detection by means of a prostate biopsy , which is why tests have been developed to detect PCA3 in urine.

The detection of PCA3 in urine was brought to market as the Progensa ™ PCA3 test by the Californian biotechnology company Gen-Probe Incorporated , based in San Diego (USA) . The costs of the test are currently not covered by the statutory health insurance (GKV). Gen-Probe was acquired by Hologic in 2012 .

Studies

The medical relevance and reliability of this test has been examined in several studies in men with suspected prostate cancer. The question of the extent to which the result of the PCA3 test (the “PCA3 score”) provides information on the expected result of a prostate biopsy was investigated. For this purpose, the test was performed both in patients with suspected prostate cancer before the first biopsy and before repeated biopsies.

The studies were carried out in the USA and Europe. The results of the investigation suggest that the PCA3 test provides information on the result of a subsequent biopsy and that the PCA3 score can be used as a decision-making aid for performing a biopsy in the overall view of the clinical and diagnostic information available for a person concerned.

A PCA-3 score of 35 is currently the cut-off value , since the ratio of sensitivity and specificity is particularly favorable here. In clinical use, however, this does not seem to be the focus. The aim is to avoid unnecessary biopsies and still include as many patients as possible with significant prostate cancer. Haese et al. have worked out in their publication by how much the number of unnecessary repeat biopsies can be reduced depending on the PCA-3 cut-off value.

PCA-3 score cut-off 20th 35
Reduction of repeat biopsies 44% 67%
false negative 9% 21%

This means that with a PCA-3 cut-off of 20, 9% of the patients still have prostate cancer.

As with almost all diagnostic tests, the PCA-3 test alone, even if it is low, does not give a hundred percent guarantee that prostate cancer is not present. The test, however, is significantly more specific than the previously used PSA value and is also not influenced by the size of the prostate gland, but it should only be assessed in conjunction with all diagnostic criteria.

literature

  • Marks et al .: PCA3 molecular urine assay for prostate cancer in men undergoing repeat biopsy . In: Urology , 2007, 69, pp. 532-535, PMID 17382159 .
  • Nakanishi et al .: PCA3 molecular urine assay correlates with prostate cancer tumor volume: Implication in selecting candidates for active surveillance. In: J Urol , 2008, 179, pp. 1804-1809, PMID 18353398 .
  • Deras et al .: PCA3: a molecular urine assay for predicting prostate biopsy outcome. In: J. Urol. , 2008, 179, pp. 1587-1592, PMID 18295257 .
  • Haese et al .: Clinical Utility of the PCA3 Urine Assay in European Men Scheduled for Repeat Biopsy In: Eur Urol . , 2008 Jun 26, PMID 18602209 .

Web links

Individual evidence

  1. ↑ A. Haese et al. In: Clinical Utility of the PCA3 Urine Assay in European Men Scheduled for Repeat Biopsy In: Eur Urol . , 2008 Jun 26, PMID 18602209 .