FeedbackQualitative Transcription-Mediated Amplification
- Aids in decision to repeat biopsy in men ≥50 years who have had one or more negative prostate biopsies and for whom a repeat biopsy would be recommended by a urologist based on current standard of care
- Not for initial prostate cancer screening
- Specimen collection must follow DRE
- Sufficient number of prostate cells must be present in urine for analysis
- PCA3 testing should not be used in patients with atypical small acinar proliferation (ASAP) on their most recent biopsy
Related Tests
Quantitative Electrochemiluminescent Immunoassay
- Preferred initial screening test for prostate cancer in conjunction with DRE
- Use to monitor patients for recurrence of cancer
Quantitative Electrochemiluminescent Immunoassay
- Percentage of free PSA compared to total PSA
- Not for initial prostate cancer screening
- May provide additional prostate cancer risk information for patients with mildly elevated total PSA and a negative DRE
- Alternative to PCA3 testing in indeterminate PSA cases
Prostate cancer is the most frequent malignant neoplasm in men and the second most common cause of cancer-related deaths in American men. PCA3 testing may be useful in conjunction with other patient information to determine whether a biopsy should be repeated in men ≥50 years.
Disease Overview
Physiology
PCA3 is noncoding RNA and is overexpressed in men with prostate cancer. PCA3 has been reported to have a median 66-fold upregulation compared with adjacent nonneoplastic tissue.
Diagnostic Issues
PCA3 testing can be helpful in determining whether to perform a repeat biopsy in patients with indeterminate PSA results.
Test Interpretation
Clinical sensitivity: 77.5% relative to prostate biopsy outcome; based on a PCA3 ratio cutoff value of 25
Clinical specificity: 57.1% relative to prostate biopsy outcome; based on a PCA3 ratio cutoff value of 25
Results
| Result | PCA3 Ratio | Interpretation |
|---|---|---|
|
Negative |
0-17 |
Associated with decreased likelihood of a positive biopsy for prostate cancer |
|
18-24 |
Should be interpreted with caution; due to normal test variability, specimens with PCA3 scores near the cutoff may yield a different overall interpretation upon repeat testing |
|
|
Positive |
25-31 |
Should be interpreted with caution; due to normal test variability, specimens with PCA3 scores near the cutoff may yield a different overall interpretation upon repeat testing |
|
>31 |
Associated with increased probability of a positive biopsy for prostate cancer |
References
-
NCCN - Clinical Practice Guidelines in Oncology: Prostate Cancer Early Detection, Version 2.2019
NCCN Clinical Practice Guidelines in Oncology: prostate cancer early detection, version 2.2019. National Comprehensive Cancer Network. [Updated: May 2019; Accessed: Jun 2020]
Online -
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Salagierski M, Sosnowski M, Schalken JA. How accurate is our prediction of biopsy outcome? PCA3-based nomograms in personalized diagnosis of prostate cancer. Cent European J Urol. 2012;65(3):110-112.
PubMed
