Comparison of diagnostic efficacy by two urine PCA3 scores in prostate cancer patients undergoing repeat biopsies.

Introduction: Urine prostate cancer gene 3 (PCA3) is significantly elevated in patients with prostate cancer and can be used for the diagnosis of prostate cancer, but its cutoff value is still controversial.

Evidence Acquisition: We searched the database on urine PCA3 in the diagnosis of prostate cancer, such as Medline, Web of Science, the Cochrane Library and Embase. Meta-analysis was performed using the random effect model and the sensitivity, specificity, diagnostic odds ratio, and area under the ROC curve (SROC) were calculated.

Evidence Synthesis: Our meta-analysis included nine studies on PCA3 scores in a total of 1721 suspected prostate cancer patients. When urine PCA3 score was 20, we obtained sensitivity of 0.83, specificity of 0.40, diagnostic odds ratio of 3.11, and the area under the SROC curve was 0.6842 (Q value 0.6404). When urine PCA3 score was 35, we found a lower sensitivity of 0.66, a higher specificity of 0.63 and a relatively lower diagnostic odds ratio of 2.84. The area under the SROC curve was 0.6715, which was slightly lower than urine PCA3 score 20.

Conclusions: Our meta-analysis suggested that when the PCA3 score cutoff value was 20, the unnecessary puncture was reduced and obtained a higher diagnostic efficacy.