A noninvasive test to determine if a man has prostate cancer or a benign enlargement of the prostate appears promising, according to a new study that says the analysis seems to be a good marker strategy to distinguish between the two.
The study, “Expression of PCA3 and PSA genes as a biomarker for differential diagnosis of nodular hyperplasia and prostate cancer,” published in the Genetics and Molecular Research journal, notes that assessment of prostate cancer antigen 3 gene (PCA3) together with prostate-specific antigen (PSA) seems to distinguish cancer from prostatic nodular hyperplasia, a benign enlargement of the prostate.
Current screening for prostate cancer relies on measuring the levels of PSA in the serum combined with a clinical digital rectal examination. But the use of molecular markers carries noninvasive potential as a new form of prostate cancer diagnosis. While there are now a large number of prostate cancer markers, the prostate cancer antigen 3 gene (PCA3) has potential value as a diagnostic marker.
Researchers investigated the expression of the PCA3 gene in prostrate cancer and prostatic nodular hyperplasia patients, and compared it to that detected in control individuals without prostate problems. In total, 59 men participated in the study, recruited at the Radiology Department of Hospital das Clínicas at Universidade Federal de Minas Gerais in Brazil, with 22 having adenocarcinoma-type prostate cancer, 26 with prostatic nodular hyperplasia, and 11 healthy men. The expression of both PSA and PCA3 gene was measured by quantitative real-time PCR in patients’ urine collected following a prostatic massage.
Researchers detected the PCA3 gene in 16 patients with prostrate cancer and in four with prostatic nodular hyperplasia — the benign enlargement of the prostate — while the control group had no expression of either marker.
When the team compared the total levels of PCA3 and PSA between patients with prostate cancer and those with prostatic nodular hyperplasia, they detected no significant differences; the same was observed when considering the PCA3/PSA ratio, and the total PSA levels.
However, when researchers categorized the groups according to the presence or absence of gene expression, they observed PCA3 frequency was higher in men with prostrate cancer when compared to the men with prostatic nodular hyperplasia. The same was observed for PSA.
These findings suggest that the presence or absence of these markers is actually a more reliable parameter to distinguish between both types of patients than genes quantification. And, these results support a potential diagnostic value of PCA3 gene, since patients without prostate changes have no measurable expression of the PCA3 gene in their urine. However, the test could not exclude patients with prostatic nodular hyperplasia. Future studies with a larger sample cohort are required to strengthen these results.