Critical Assessment of Preoperative Urinary Prostate Cancer Antigen 3 on the Accuracy of Prostate Cancer Staging
Critical Assessment of Preoperative Urinary Prostate Cancer Antigen 3 on the Accuracy of Prostate Cancer Staging
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DOI：
10.1016/j.eururo.2010.10.024
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发表时间：
2011-01-01
期刊：
影响因子：
23.4
通讯作者：
Haese, Alexander
中科院分区：
文献类型：
--
作者：
Auprich, Marco;Chun, Felix K. -H.;Haese, Alexander
背景：关于前列腺癌抗原3 （PCA3）评分在根治性前列腺切除术（RP）后更好地识别病理特征的分期意义的认识有限且存在争议。目的：我们的目的是研究PCA3的临床分期意义，以确定RP标本的病理有利和/或不利特征。设计、设置和参与者：来自三个三级转诊中心的连续接受RP的男性的完整回顾性临床和病理数据，包括术前PCA3评分（n = 305）和计算机辅助平面测量肿瘤体积数据（n = 160）。干预：所有患者均接受RP治疗。测量方法：使用PROGENSA法（Gen-Probe, San Diego， CA， USA）评估PCA3评分。除标准危险因素（年龄、直肠指检、前列腺特异性抗原、前列腺体积、活检Gleason评分、阳性核心百分比）外，在logistic回归模型中使用5种不同的PCA3编码来确定5种不同的病理终点：(1)小体积疾病（= 7）。在有和没有PCA3的模型中，使用接收器算子特征分析的曲线下面积（AUC）对每个终点的精度估计进行量化。结果和局限性：PCA3评分在小体积病变和不显著的PCa中显著降低(p
Background: Knowledge about the staging significance of the prostate cancer antigen 3 (PCA3) score to better identify pathologic features after radical prostatectomy (RP) is limited and controversial.Objective: Our aim was to study the clinical staging significance of PCA3 to identify pathologic favorable and/or unfavorable features in the RP specimen.Design, setting, and participants: Complete retrospective clinical and pathologic data of consecutive men who had undergone RP from three tertiary referral centers including preoperative PCA3 scores (n = 305) and computer-assisted planimetrically measured tumor volume data (n = 160) were available.Intervention: All patients were treated with RP.Measurements: PCA3 scores were assessed using the PROGENSA assay (Gen-Probe, San Diego, CA, USA). Beyond standard risk factors (age, digital rectal examination, prostate-specific antigen, prostate volume, biopsy Gleason score, percentage of positive cores), five different PCA3 codings were used in logistic regression models to identify five distinct pathologic end points: (1) low-volume disease (= 7. Accuracy estimates of each end point were quantified using the area under the curve (AUC) of the receiver operator characteristic analysis in models with and without PCA3.Results and limitations: PCA3 scores were significantly lower in low-volume disease and insignificant PCa (p