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Pca3 Urine Test For Prostate Cancer

Diagnosis Of Prostate Cancer

Should You Get a PCA3 Test?

Check out this factsheet for a summary of the video.

Diagnosis is the process of finding out the cause of a health problem. Diagnosing prostate cancer usually begins with a visit to your family doctor. Your doctor will ask you about any symptoms you have and do a physical exam. Based on this information, your doctor may refer you to a specialist called a urologist or order tests to check for prostate cancer or other health problems. A urologist is a doctor who specializes in treating conditions of the genital and urinary tracts, including the prostate.

The process of diagnosis may seem long and frustrating. Itâs normal to worry, but try to remember that other health conditions can cause similar symptoms as prostate cancer. Itâs important for the healthcare team to rule out other reasons for a health problem before making a diagnosis of prostate cancer.

The following tests are usually used to rule out or diagnose prostate cancer. Many of the same tests used to diagnose cancer are used to find out the stage . Your doctor may also order other tests to check your general health and to help plan your treatment.

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Urine Biomarkers Of Prostate Cancer

PCA-3, a noncoding prostate-specific RNA, was found to be overexpressed in prostate cancer tissue compared with benign tissue.198,199 Urine assays for PCA3 have been developed that appear to improve the specificity of prostate cancer detection in response to an abnormal serum PSA,200 When compared with %fPSA, a PCA3 score has been shown to be a superior predictor of prostate cancer on a repeat biopsy when an initial biopsy was negative.201 Although PCA3 may have a higher specificity when used for prostate cancer detection, urine testing for PCA3 exhibits a lower sensitivity when compared with serum PSA testing.

Pongali Raghavendra, Thammineni Pullaiah, in, 2018

Search Strategy And Study Selection

A comprehensive, computerized literature search was performed in PubMed and Embase for work published through December 2014 using a combination of the following key words: AND AND . Then, the reference sections of the identified publications were searched to identify additional potentially relevant articles. Studies included in our meta-analysis had to meet the following criteria: case-control or cohort design diagnostic test using PCA3 itself or in combination with other biomarkers and prostate biopsy as the gold standard.

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C Data Abstraction And Data Management

Data from all included studies will be abstracted using DistillerSR software into standard evidence tables by one reviewer, and checked for accuracy and completeness by a second reviewer. Data abstraction tables will be pilot tested for completeness on a group of select studies and will be revised as necessary before full data abstraction begins. Project staff will meet regularly to discuss the results at each phase, review studies that are difficult to classify, and address any questions that the team may have. Authors of included studies will be contacted if clarification of methods or results is needed.

The data elements to be abstracted were established in consultation with the TEP and include:

Study Description:

  • Systematic review/meta-analysis

Evidence Tables

Templates for evidence tables will be created in Microsoft Access® and Excel®. One reviewer will perform primary data abstraction of all data elements into the evidence tables, and a second reviewer will review articles and evidence tables for accuracy. Disagreements will be resolved by discussion and if necessary by consultation with a third reviewer. When small differences occur in quantitative estimates of data from published figures, the values will be obtained by averaging the two reviewersâ estimates.

New Prostate Cancer Blood Test

PCA3: Marqueur urinaire du cancer de la prostate

If you have an abnormal PSA score, your doctor may recommend another newertest that gives a better sense of yourprostate cancer risk. The prostate health index is one such test that is a more accurateblood test and measures your risk for having prostate cancer. Its approvedby the FDA for men who have PSA scores between 4 and 10.

What are the benefits of the PHI test?

  • Fewer unnecessary biopsies: Some men who have elevated PSA scores are unsure about getting an invasive biopsy. This tool can be used to better determine whether your risk is high enough to warrant a biopsy.
  • More accurate: This test is better at detecting prostate cancer. It can also detect whether you have a more aggressive type of cancer. This information can guide doctors to a more targeted treatment plan for you.

If you score low on the PHI test, your doctor may recommend monitoring youover time to see if your levels rise enough to cause concern.

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Can The Test Be Performed In My Healthcare Practitioners Office

The DRE will be performed in your healthcare practitioners office and, most likely, so will the urine collection as it is the first urine collected after the DRE. However, the testing requires specialized equipment and your sample will be sent to a laboratory for testing. Not all labs perform this test, so your sample may be sent to a reference laboratory.

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Lncrna And Prostate Cancer

The longer class of ncRNAs is known as long intergenic RNA , with sizes ranging from a few hundred to thousands of nucleotides. lncRNAs can regulate protein-encoding genes by affecting transcription and chromatin state by mechanisms distinct from those used by small ncRNAs. Thus genetic alterations and aberrant expression of lncRNAs can be a causal factor in disease. Several lncRNAs pertinent to prostate cancer have been identified. A 3.7-kb lncRNA known as PCA3 has been mapped to chromosome 9q21-22 and shown to be highly overexpressed in prostate cancer samples. Genetic variation in lncRNAs has been found to affect prostate cancer risk. Microarray profiling of intronic transcripts identified many ncRNAs expressed in prostate cancer samples, and the expression levels of some correlate with the extent of prostate tumor cell differentiation.14 By high-throughput RNA sequencing of 102 prostate tissues and cell lines, Prensner and colleagues identified 121 unannotated prostate cancerâassociated ncRNA transcripts and have characterized one of them, PCAT-1, as a prostate cancerâspecific ncRNA functionally implicated in disease progression.

Xiaotong Hu, Shuiping Liu, in, 2017

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Pca3 Test And Prostate Cancer

Taking a biopsy of prostate cancer is one of the most widely debated steps to diagnose and treat men with lower urinary tract symptoms.

It is the gold-standard procedure to give men a final diagnosis of prostate cancer and stage the disease.

However, it does have severe side effects and long-lasting health outcomes.

This is especially the case because biopsies are often performed more than once, and they are sometimes an undue risk .

Among the side effects of a prostate biopsy, we can have:

  • Chronic bleeding of the urinary tract.
  • Chronic urinary pain .

Doctors should use every diagnostic tool available before resulting to unnecessary prostate biopsies.

Even so, the PSA test, digital rectal examination, and imaging tests may still give out false positives.

Recent investigations have pointed out that the PCA3 test might soon become the solution to this medical dilemma.

When Is It Ordered

PCA3 Urinary Biomarker Detection Test for the Diagnosis of Prostate Cancer

The test may be ordered when a man has had an elevated PSA blood test and/or abnormal digital rectal exam and one or more previous negative prostate biopsies. It may be ordered when another biopsy would normally be recommended and a healthcare practitioner wants to evaluate the likelihood that the repeat biopsy would be positive.

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Potential Long Noncoding Rna Biomarkers In Cancer And Other Diseases

lncRNAs play important regulatory roles in transcription, translation, chromatin modification, and cellular organization. Misregulation of lncRNAs is found associated with various human diseases. Though lncRNAs are only recently discovered, at least 321 experimentally verified lncRNAs associated with 221 various types of diseases, which are most related to cancer . The lncRNAs represent another group of potential biomarkers for cancer diagnosis and prognosis.

Prostate cancer antigen 3 is a well-studied lncRNA and the most specific to prostate cancer as it is not expressed in other normal human tissues. PROGENSA PCA3 test is the first urine-based molecular diagnostic test approved by the Food and Drug Administration . The sensitivity and specificity of urine PCA3 expression for PCa diagnosis reach 62 and 75%, respectively, supporting PCA3 as a reasonable marker for prostate cancer diagnosis .

HOX transcript antisense RNA is another well-studied lncRNA. In cervical cancers, high serum levels of HOTAIR were significantly correlated with tumor recurrence and shorter overall survival .

Dong et al. found that the combination of CUDR, LSINCT-5, and PTENP1 provided the best diagnostic value in GC with an AUC of 0.92, a sensitivity of 74.1%, and a specificity of 100%. They were also sufficiently sensitive and specific for early GC detection and distinguishing benign peptic ulcers from GC .

For reference, more potential lncRNA biomarkers are listed in Table 18.3.

LncRNAs

What Does The Test Result Mean

The PCA3 test result is a ratio of PCA3 mRNA to PSA mRNA that is reported as a score. The laboratory report provides a cut-off number at which the score is considered positive.

The PCA3 test does not provide a definitive answer as to whether a man has a cancer or not. Rather, healthcare practitioners consider the test results in conjunction with other laboratory and clinical data to determine the likelihood that a repeat biopsy will be positive.

A PCA3 score that is less than the laboratorys established cutoff is considered negative and is associated with a likelihood of a positive biopsy.

A PCA3 score that is greater than the laboratorys established cutoff is considered positive and is associated with an increased likelihood of a positive biopsy. Some labs provide a range in which PCA3 is considered positive but with a caution about interpreting results that are close to the cut-off value, due to normal test variability.

About 90% of prostate cancers will over-express PCA3, but the PCA3 result cannot be used to diagnose or completely rule out prostate cancer. It just helps to guide decision-making on performing another biopsy. Prostate biopsy is still the gold standard for diagnosing prostate cancer.

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What To Expect During A Pca3 Test

Prostate cancer PCA samples are taking following a two-step procedure. During the first step, your urologist will need to perform a digital rectal exam or a prostate massage.

This procedure is performed by inserting one or two lubricated and gloved fingers in the rectum and pushing forward to meet and feel the prostate gland. In the process, your prostate will release a sample of cells into the prostatic urethra.

During the second step, you will need to provide a urine sample. It is essential to take the first stream of urine instead of the midstream doctors will recommend in other tests.

This initial stream drags along the prostatic cells in your prostatic urethra, and the sample is taken to the lab for PCR analysis. 20 to 30 mL of the first catch urine is what the laboratory will need for testing.

Whats The Difference Between The Pca3 Test And The Psa Test

PROGENSA PCA3 Assay Approved to Help Determine if Repeat Prostate ...

The PCA3 test measures the levels of prostate cancer gene 3. This gene is found in high levels in prostate cancer cells. The test isnt affected by an enlarged prostate, prostatitis, or other conditions of the prostate gland.

PSA tests measure the levels of prostate-specific antigen in your blood. If your levels are high, or if they rise rapidly, you may have prostate cancer. But elevated PSA levels can be caused by many things besides prostate cancer, including:

  • benign prostatic hyperplasia , often referred to as an enlarged prostate, which is a common, noncancerous condition
  • prostatitis, or inflammation or infection of the prostate
  • pressure on the prostate from a digital rectal exam or catheter

PSA tests used to be given annually to men older than 50 years, but theyre no longer recommended as a primary screening method by most medical experts. There are several reasons for this:

  • There are a high number of false positives with PSA tests.
  • Some men have prostate cancer even when their PSA levels are low, so the test may give false negatives.
  • In many men, prostate cancer grows so slowly that watchful waiting is advised rather than treatment.
  • Because the diagnosis of cancer can be alarming, some men have unnecessary biopsies or surgery.
  • Incontinence and sexual problems can be common side effects of prostate cancer treatment.

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Prostate Cancer Testing: Psa Vs Pca3posted On Bynaturmend Staff 0 Comments

Although its not prostate cancer month, I decided to write about prostate health, because it has been a popular topic of discussion at my last few seminars. Prostate Specific Antigen testing is most commonly used to determine the health of the prostate gland and can be tested simply through a blood test. For a long time now, high PSA levels have shown to be correlated with prostate cancer. However, PSA levels can also be equally elevated in other non-cancerous conditions such as: Benign Prostate Hypertrophy , urinary tract infections and prostate infections . So, if PSA levels can be elevated in a variety of conditions, how would you know if your high PSA levels are due to cancer or another prostate condition? The answer is you dont know.

But, there is another laboratory test you could do! The Prostate Cancer Antigen 3 test has been shown to be extremely effective in helping patients/doctors come to a biopsy decision, investigate further for an initial cancer diagnosis and even monitor the progression of cancer numerically while undergoing active treatments. The PCA3 test is not a blood test. A digital rectal examination is performed by the physician the purpose being to massage the prostate gland and mobilize PCA3 from the prostate into the urine. Immediately following the DRE, first-urine is collected. This first-urine is rich in PCA3 and is sent to the laboratory for testing.

Prostate Cancer Urine Test Predicts Biopsy Test Results

Nick Mulcahy

The urine test, known as the PCA3 assay, measures a gene that is overexpressed in prostate cancer. It is approved in Europe and marketed as Progensa. Its uses include guiding biopsy decisions in men who have an elevated prostate-specific antigen level but who also have one or more prior negative biopsy results, despite the PSA results.

The assay has not yet been submitted for Food and Drug Administration approval in the United States.

In the new study of 1072 men, those who had higher PCA3 scores were more likely to have a positive biopsy result and thus prostate cancer, said Jack Groskopf, PhD, at a meeting press conference. He is director of research and development in cancer diagnostics at Gen-Probe Incorporated, the manufacturer of the PCA3 test.

PCA3 is overexpressed in more than 90% of prostate cancers.

“PCA3 provides direct detection of prostate cancer cells,” said Dr Groskopf.

“PCA3 is overexpressed in more than 90% of prostate cancers,” said Dr. Groskopf. Unlike PSA, it is not expressed in other prostate disorders, such as prostatitis or benign prostatic hyperplasia, he added.

Results from the new study also indicated that higher PCA3 scores were associated with a higher biopsy Gleason score , Dr. Groskopf added. “This is evidence that PCA3 may help identify aggressive cancers,” he commented.

Study Results

The men all had previous negative biopsy results and serum PSA levels between 2.5 and 10 ng/mL.

Send press releases and comments to .

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Ask A Laboratory Scientist

This form enables patients to ask specific questions about lab tests. Your questions will be answered by a laboratory scientist as part of a voluntary service provided by one of our partners, American Society for Clinical Laboratory Science. Please allow 2-3 business days for an email response from one of the volunteers on the Consumer Information Response Team.

F Grading The Evidence For Each Key Question

PCA3

We will grade the strength of evidence for primary outcomes by using the standard process of the Evidence-based Practice Centers as outlined in the Methods Guide.10,20 The grade will be based on four major domains: risk of bias, consistency, directness, and precision of the evidence. We will classify the bodies of evidence pertaining to each primary outcome into four basic grades: high, moderate, low, and insufficient .20 Additional domains such as dose-response association, plausible confounding, strength of association, and publication bias will be assessed and reported if applicable.

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Psa Test: The Current Prostate Screening Standard

Before recommending when you should be screened for prostate cancer, yourdoctor will consider many factors, such as:

  • Family history, particularly whether any of your family members have had prostate cancer
  • Race, as African-American men have a higher risk of developing prostate cancer

If your doctor determines you should undergo screening, he or she will mostlikely recommend the PSA test. For more than 30 years, the PSA test hasbeen the gold standard in prostate cancer screening. This simple blood testmeasures how much prostate-specific antigen is in your blood.

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Case : Elevated Psa Level Irritative Voiding Symptoms

Acute prostatitis is known to cause marked elevation in serum PSA levels less dramatic is the potential effect that inflammation found incidentally in prostate tissue specimens may exert on serum PSA levels.17 Between these extremes lies a wide spectrum of clinical presentations, ranging from minimal to severe, and open to subjective interpretation of symptoms by both patient and physician. Complicating this matter is the difficulty in establishing a specific diagnosis of subacute or chronic prostatitis.

Figure 4 shows the PSA levels in a 55-year-old man under observation over years with mild voiding symptoms not requiring treatment. He then returned with a mild-to-moderate increase in irritative voiding symptoms over the previous few weeks. DRE revealed a slightly enlarged, smooth, symmetric, nontender prostate. Urinalysis was acellular, and results from culture were negative. His serum PSA level was increased to 9.1 ng/mL. The PCA3 score was 22.5, which is below the cutoff of 35 for optimal sensitivity and specificity.6 A presumptive diagnosis of prostatitis was made, and he was treated with 3 weeks of a quinolone antibiotic. Eventually his serum PSA levels returned to former levels. Biopsy was not performed.

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