Urinary Test Score Unchanged by Chronic Prostatitis

The influence of chronic prostatitis on the potential new biomarkers of prostate cancer (PCa) found in male urinary samples has been determined.

Prostate cancer gene 3 (PCA3) is one of the most promising candidate markers for prostate cancer (PCa) diagnosis and it has been found to be overexpressed in up to 95% of all prostate cancer patients tested and is 60- to 100-less expressed in noncancerous than in cancerous tissues.

Scientists the Hospices Civils de Lyon (France) collected urine specimens for cytological analysis and culture from 38 patients with clinical suspicion of chronic prostatitis whose mean-age was 37.5 years. The specimens were collected between March and June 2010 and a postprostatic massage urine sample was used for the urinary PCA3 test. None of the patients had history of prostate cancer.

The PCA3 and Prostate Specific Antigen (PSA) ribonucleic acid (RNA) were quantified in parallel using the Progensa PCA3 Assay (Gen-Probe; San Diego, CA, USA). Urine samples were considered as noninformative for prostate cells if number of PSA messenger RNA (mRNA) transcripts detected was less than 10,000. A negative PCA3 test was considered if PCA3 score was less than the usual cutoff of 35. The PCA3 test was considered positive if PCA3 score was higher than or equal to 35.

Four patients had an eventual diagnosis of urethritis and all had a PCA3 score less than 5. Among the remaining 34 patients, seven had bacterial chronic prostatitis, 11 had abacterial chronic prostatitis, and 16 had noninflammatory prostatodynia. All these patients had a PCA3 score less than 28, that is, under the cutoff of 35, which is commonly used for prostate cancer diagnosis.

The authors concluded that prostate massage included within the Meares–Stamey four-glass localization test allows informative samples for urinary PCA3 test. The PCA3 score was found to be negative with less than the usual cutoff of 35, in all tested patients, suggesting that PCA3 test can be used as a valuable tool in patients with raised PSA and suspicion of chronic prostatitis to distinguish those patients who will really benefit from prostate biopsy. The study was published in the April 2012 edition of the journal the Prostate.

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Hospices Civils de Lyon
Gen-Probe