The prostate cancer gene 3 (PCA3) urine test is superior to percent-free PSA in predicting prostate biopsy outcome, data show.


The researchers studied 463 men who had one or two negative prostate biopsies. Following digital rectal examination, first-catch urine was collected to measure PCA3 mRNA concentration and calculate PCA3 score.

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The investigators compared this score with biopsy outcome and compared the diagnostic accuracy of the PCA3 assay with that of percent-free PSA.


The positive repeat biopsy rate was 28%. The higher the PCA3 score, the greater the probability of a positive repeat biopsy. Using a PCA3 score cutoff of 35 had a greater diagnostic accuracy than percent-free PSA with a cutoff of 25%, the investigators reported in European Urology (online ahead of print).


Additionally, PCA3 score was significantly higher in men with high-grade prostate intraepithelial neoplasia (HGPIN) compared with men without HGPIN. It also was significantly higher in men with a Gleason score of 7 or higher than in men with lower Gleason scores and significantly higher in men with clinical stage T2 versus T1.