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PCA3: A new tool to diagnose prostate cancer (PCa) and a guidance in biopsy decisionsTable 1.Characteristics of the population undergone BX or ReBX post PCA3 results.Men with neg biopsy Men with HGPIN/ASAP Men with pos biopsy All evaluable menn = 31 biopsy n = 38 n = 45 n = 114Median mean ± SD Median mean ± SD Median mean ± SD Median mean ± SDnumber (%) number (%) number (%) number (%)within the class within the class within the class within the classAge (yr; n = 31; 38; 45; 114) 68 66.9 ± 6.5 66 66.4 ± 6.4 68 68.5 ± 7.1 68 67.4 ± 6.8At least one previous negative biopsy (%) 12 (38.71%) 8 (21.05%) 11 (24.44%) 31 (27.19%)PSA (ng/ml; n = 31; 36; 45; 112) 7 8 ± 6.4 7.23 8.8 ± 6.2 6.95 9.9 ± 10.4 7 9 ± 8.1Men with serum PSA total< 4 ng/ml-n; (%) 6 (19.35%) 5 (13.16%) 5 (11.11%) 16 (14.04%)4-10 ng/ml-n; (%) 18 (58.06%) 24 (63.16%) 28 (62.22%) 70 (61.4%)> 10 ng/ml-n; (%) 7 (22.58%) 9 (23.68%) 12 (26.67%) 28 (24.56%)Prostate volume (ml; n=7; 12; 8; 27) 58 60 ± 13.9 67 60.3 ± 29 40 40.6 ± 11 57 53.8 ± 23.1Men with suspicious DRE (n; %) 8 (25.81%) 7 (18.42%) 12 (26.67%) 27 (23.68%)PCA3 score 48 54.9 ± 26.2 66 79.6 ± 44.4 97 141.6 ± 120.1 70 97.4 ± 88.5between the groups of patients with negative and positivebiopsy.Statistical analysis showed also that the difference inPCA3 score between negative and ASAP/PIN patients wassignificant (p = 0.00204; two-tailed t-student test) whereasthe difference in PCA3 score between HGPIN/ASAPand positive patients was not significant.The graph in Figure 1 summarizes the relationshipbetween PCA3 score and prostate biopsy results.All the patients who underwent post-PCA3 test biopsyFigure 1.Prostate cancer gene (PCA3) score vs prostate biopsy results. PCA3 score Mean ± SDand median were: 54.9 ± 26.2 and 48 for men with negative biopsy, 79.6 ± 44.4and 66 for men with HGPIN/ASAP biopsy, 141.6 ± 120.1 and 97 for men with PCa biopsy.PCA3 score vs prostate biopsy results (n = 114)(n = 114) were classified in 4 PCA3 score classes as follows:< 35 (n = 9), 35-49 (n = 26), 50-100 (n = 48),> 100 (n = 1). The results are shown in the Table 2. Only9% of patients (4/45) with a positive biopsy were in the< 35 PCA3 score class, whereas 11.1% (5/45) of patientswith a positive biopsy were in the PCA3 score 35-49class, 35.5% (16/45) in the 50-100 PCA3 score class and44.4% (20/45) in the > 100 PCA3 score class. These datademonstrate a direct correlation between the quantitativePCA3 score and the probability of a positive prostatebiopsy. Interestingly, mostpatients (22/38, 57.9%) withdiagnosis of HGPIN/ASAP atbiopsy were concentrated inthe 50-100 PCA3 score class.In conclusion, our resultsindicate that higher PCA3score may be predictive of apositive result in patientsundergoing prostate biopsy.Benign HGPIN/ASAP CaPn = 31 n = 38 n = 45DISCUSSIONIn this study we determinedthe PCA3 score and theserum tPSA in a panel of 915patients and in 114 of themwe correlated them with theresult of prostate biopsy. Ourresults indicated that themean PCA3 score was significantlylower in patientswith negative biopsy than inpatients diagnosed withASAP/PIN at biopsy orArchivio Italiano di Urologia e Andrologia 2010; 82, 17