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Volume 19, Issue 2 (March 2017) 19, 238–243; DOI:10.4103/1008-682X.167715

Prostate cancer antigen 3 moderately improves diagnostic accuracy in Chinese patients undergoing first prostate biopsy

Fu-Bo Wang, Rui Chen, Shan-Cheng Ren, Xiao-Lei Shi, Ya-Sheng Zhu, Wei Zhang, Tai-Le Jing, Chao Zhang, Xu Gao, Jian-Guo Hou, Chuan-Liang Xu, Ying-Hao Sun

Department of Urology, Shanghai Changhai Hospital, Second Military Medical University, Shanghai, China.

Correspondence: Prof. YH Sun (sunyh@medmail.com.cn)

Date of Submission 25-Jan-2015 Date of Decision 30-Mar-2015 Date of Acceptance 27-Aug-2015 Date of Web Publication 19-Jan-2016


Prostate cancer antigen 3 (PCA3) is a biomarker for diagnosing prostate cancer (PCa) identified in the Caucasian population. We
evaluated the effectiveness of urinary PCA3 in predicting the biopsy result in 500 men undergoing initial prostate biopsy. The
predictive power of the PCA3 score was evaluated by the area under receiver operating characteristic (ROC) curve (AUC) and by
decision curve analysis. PCA3 score sufficed to discriminate positive from negative prostate biopsy results but was not correlated with
the aggressiveness of PCa. The ROC analysis showed a higher AUC for the PCA3 score than %fPSA (0.750 vs 0.622, P = 0.046)
in patients with a PSA of 4.0–10.0 ng ml−1, but the PCA3‑based model is not significantly better than the base model. Decision
curve analysis indicates the PCA3‑based model was superior to the base model with a higher net benefit for almost all threshold
probabilities, especially the threshold probabilities of 25%–40% in patients with a PSA of 4.0–10.0 ng ml−1. However, the AUC
of the PCA3 score (0.712) is not superior to %fPSA (0.698) or PSAD (0.773) in patients with a PSA >10.0 ng ml−1. Our results
confirmed that the RT‑PCR‑based PCA3 test moderately improved diagnostic accuracy in Chinese patients undergoing first prostate
biopsy with a PSA of 4.0–10.0 ng ml−1

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