Prostate Cancer Antigen 3 to Sel Stop, Go, or Proceed with Cautio

actually a much smaller subset of men for whom PCA3 will Based on this threshold to recommend biopsy, anymanwith EU RO P E AN URO LOG Y 6 3 ( 2 0 1 3) 2 1 0 – 2 1 3 avai lable at www.sciencedirect.com journal homepage: www.europeanurology.comThe ratio of PCA3 messenger RNA (mRNA) to PSA mRNA insuspicious rectal exam. The goal is to identify a subset of men for whom biopsy may be avoided. 2. PCA3 performance One potential marker to aid in this decision-making process is PCA3. PCA3 is a gene that is overexpressed in PCa tissue. a nomogram score without PCA3 of 115 should have a biopsy, regardless of PCA3. Thus, for these men, PCA3 adds costwithoututility. Alternatively,menwith scores<87.5not including PCA3 (which contributes 27.5 points), even if PCA3 were ‘‘positive,’ ’ cannot end up with a score of 115 and thus would be recommended for biopsy. As such, the nomogram presented by the authors—under the assumption that a 30% biopsy positivity rate is the threshold for biopsy—suggeststhe presence of any PCa and high-grade PCa on initial PNB [2]. The nomogram was developed and internally validated using an international cohort of men that had undergone first biopsy for either elevated PSA (2.5–10 ng/ml) or affect management. For example, the 30 % PCa probability threshold proposed by the authors to be used for PNB [2] corresponds toa totalnomogramscoreofapproximately115.antigen 3 (PCA3) to an existing clinical nomogram to predictPlatinum Priority – Editorial and Reply from A Referring to the article published on pp. 201–209 of t