Evaluation of the urine mRNA-PCA3 expression level in prostate patients; comparison between benign prostatic hyperplasia and cancer

Abstract

Introduction: Prostate cancer is among the most common malignancies in men which can be well-managed if early diagnosed. Nevertheless, to date, no accurate index has been detected in order to differentiate prostate cancer from the other benign conditions practically except biopsies that is an invasive procedure. Objectives: The current study is aimed to assess the values of urinary prostate cancer antigen 3 (PCA3) in prostate cancer diagnosis. Patients and Methods: This case-control study was conducted on 28 patients with elevated levels of prostate-specific antigen (PSA) who underwent transrectal prostate biopsies in 2019. The urinary level of PCA 3 was measured using real-time polymerase chain reaction (RT-PCR). Ultrasonography was performed to assess the volume of prostate, as well. PSA density (PSAD) was defined as PSA divided by prostate volume. The patients were divided into two groups of benign prostatic hyperplasia (BPH) or prostate cancer based on prostate biopsy pathological report. The values of PCA 3 were evaluated. Results: PCA 3 had accuracy of 0.708 at cut-off point of 27.75 with measured AUC of 0.720 (95% CI: 0.510- 0.931), sensitivity and specificity of 72% and 69%, respectively. PSA had accuracy, sensitivity, and specificity of 0.708, 70% and 71.4% at cut-off of 9, whereas PSAD had 0.667, 88% and 50% at cut-off of 4.8, respectively. Conclusion: Based on the findings of this study, urinary PCA 3 can be considered as a valuable biomarker for the prediction of malignancy in prostate biopsies with the sensitivity and specificity of 72.7% and 69.2% at the cut-off level of 27.75, respectively.