The PROGENSA® PCA3 (Prostate Cancer Antigen 3) test, performed in Tecnobios Prenatale Eurogenlab, is the first specific molecular test for prostate carcinoma.
Compared to the PSA test, it offers the advantage to predict with a higher probability, a
positive result of a following prostate biopsy, in patients with previous negative result.
In the Italian male population the prostate cancer is the most frequent cancer, with an incidence of 12%. Currently, patients with suspected prostate cancer diagnosis are subjected to the PSA (Prostate Specific Antigen) dose, followed by DRE (digital rectal exam with prostate massage, Fig.1). The PSA is a nothing much selective parameter, cause of the increase in blood levels may be due both to the presence of a prostate cancer and other factors (prostate swelling, prostatitis, ...).
Furthermore, the patients submitted to prostate biopsy (10-25%) with a the negative results show a prostate cancer diagnosis.
So the margin of uncertainty often remains consistent even after the execution of the PSA test and / or biopsy.
The PCA3 test allows to quantify the level of mRNA produced by the gene PCA3 in a
sample of urine (Fig.2); the greater is the amount of PCA3, the greater will be the probability of the presence of a neoplasm. The test involves a score calculating (PCA3 score) obtained from the amount of mRNA PCA3 and PSA mRNA ratio.
Several studies have shown that the scores (Figure 3) obtained with PROGENSA® PCA3 correlate with the size of the prostate cancer; that can help doctors to identify those
patients who require aggressive therapy, differentiating by those who, suffering from
localized forms and with low-grade, can be assigned to active surveillance. For example an high PCA3 score indicates an increased probability of a positive biopsy, that is the presence of cancer cells in the prostate; while a low PCA3 score indicates a decreased probability of a positive biopsy. The PCA3 test can also be used in subjects with one or more previous negative biopsies to determine the probability that a further biopsy could be positive, or for assessing the need for a next biopsy.
In conclusion the PCA3 test, in addition to the existing clinical data, help you to avoid
repeated biopsies (surgery that can be painful and cause unwanted side effects),
especially in those patients with contradictory results, minimizing the sense of anxiety and
discomfort often felt by those who must live with the suspicion of prostate cancer.
The analysis response of PCA3 is available, after 15 days, average, from urine collection.
The urine sample, obtained by a digital rectal exam, is performed by medical specialist
Haese A et al. (2008). "Clinical Utility of the PCA3 Urine Assay in European Men Scheduled for Repeat Biopsy". Eur. Urol. 54 (5): 1081.
Marks LS et al. (2007). "PCA3 molecular urine assay for prostate cancer in men undergoing repeat biopsy". Urology 69 (3): 532–5.
de la Taille A (2007). "Progensa PCA3 test for prostate cancer detection". Expert Rev. Mol. Diagn. 7 (5): 491–7.
Nakanishi H et al. (2008). "PCA3 molecular urine assay correlates with prostate cancer tumor volume: implication in selecting candidates for active surveillance". J. Urol. 179 (5): 1804–10.
Whitman EJ et al. (2008). "PCA3 Score Before Radical Prostatectomy Predicts Extracapsular Extension and Tumor Volume". J. Urol. 180 (5): 1975.