Vol. 46 (x): 2020 January 1.[Ahead of print]

doi: 10.1590/S1677-5538.IBJU.2019.0360


REVIEW ARTICLE

Zhiqiang Qin 1, Jianxiang Yao 2, Luwei Xu 1, Zheng Xu 1, Yuzheng Ge 1, Liuhua Zhou 1, Feng Zhao 1, Ruipeng Jia 1
1 Department of Urology, Nanjing First Hospital, Nanjing Medical University, Nanjing, China; 2 Department of Urology, Huzhou first people’s hospital, Huzhou, China

ABSTRACT

Background: The diagnostic value and suitability of prostate cancer antigen 3 (PCA3) for the detection of prostate cancer (PCa) have been inconsistent in previous studies.
Thus, the aim of the present meta-analysis was performed to systematically evaluate the diagnostic value of PCA3 for PCa.
Materials and Methods: A meta-analysis was performed to search relevant studies using online databases EMBASE, PubMed and Web of Science published until February 1st, 2019. Ultimately, 65 studies met the inclusion criteria for this meta-analysis with 8.139 cases and 14.116 controls. The sensitivity, specifi city, positive likelihood ratios (LR+), negative likelihood ratios (LR−), and other measures of PCA3 were pooled and determined to evaluate the diagnostic rate of PCa by the random-effect model.
Results: With PCA3, the pooled overall diagnostic sensitivity, specifi city, LR+, LR−, and 95% confi dence intervals (CIs) for predicting signifi cant PCa were 0.68 (0.64-0.72), 0.72 (0.68-0.75), 2.41 (2.16-2.69), 0.44 (0.40-0.49), respectively. Besides, the summary diagnostic odds ratio (DOR) and 95% CIs for PCA3 was 5.44 (4.53-6.53). In addition, the area under summary receiver operating characteristic (sROC) curves and 95% CIs was 0.76 (0.72-0.79). The major design defi ciencies of included studies were differential verifi cation bias, and a lack of clear inclusion and exclusion criteria.
Conclusions: The results of this meta-analysis suggested that PCA3 was a non-invasive method with the acceptable sensitivity and specifi city in the diagnosis of PCa, to distinguish between patients and healthy individuals. To validate the potential applicability of PCA3 in the diagnosis of PCa, more rigorous studies were needed to confirm these conclusions.

Keywords: prostate cancer antigen 3, human [Supplementary Concept]; Prostate cancer, familial [Supplementary Concept]; Meta-Analysis [Publication Type]

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