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Performance of PCA3 and TMPRSS2:ERG Within the Prostate Cancer Prevention Trial Risk Calculator Version 2 in a
Jurate Kemesiene1, Carlos Nicolau2, Gytis Cholstauskas3
1Department of Radiology, Medical Academy, Lithuanian University of Health Sciences, Kaunas, Lithuania.
Research and Reports in Urology
|April 3, 2025
Summary
Novel urinary biomarkers, prostate cancer antigen 3 (PCA3) and TMPRSS2-ERG fusion genes (T:E), significantly improve prostate cancer risk prediction. Integrating these into the PCPTRC2 calculator enhances detection accuracy for clinically significant prostate cancer in biopsy-naïve men.
Area of Science:
- Urology
- Oncology
- Biomarker Discovery
Background:
- Prostate cancer (PCa) poses a significant health burden, with current screening methods like PSA testing lacking specificity.
- This often leads to unnecessary biopsies and overtreatment, highlighting the need for improved diagnostic tools.
Purpose of the Study:
- To evaluate the integration of urinary biomarkers PCA3 and T:E into the PCPTRC2 risk calculator.
- The goal was to enhance the detection of clinically significant prostate cancer (csPCa) in a Lithuanian cohort.
Main Methods:
- A prospective study involved 246 men undergoing initial prostate biopsy.
- Urinary samples were analyzed for PCA3 and T:E post-digital rectal examination (DRE).
- Risk calculators (basic PCPTRC2 and biomarker-enhanced versions) were compared using biopsy results.
Main Results:
- The area under the curve (AUC) for PCa detection improved from 59.6% (original PCPTRC2) to 76.2% (with PCA3) and 79.5% (with PCA3 and T:E).
- Biomarker-enhanced models showed significantly higher sensitivity (p<0.001) compared to the original PCPTRC2.
- No significant difference was found in distinguishing csPCa from non-csPCa between the models.
Conclusions:
- Incorporating PCA3 and T:E into PCPTRC2 significantly enhances diagnostic accuracy for PCa detection in biopsy-naïve patients.
- These findings suggest the potential for optimizing risk calculators in clinical practice.
- Larger cohorts are recommended for further validation of these results.
