Diagnostic Performance of the Prostate Cancer Antigen 3 Test in Prostate Cancer: Systematic Review and Meta-analysis

Abstract

The purpose of this study was to assess the diagnostic accuracy of prostate cancer antigen 3 (PCA3) test for the diagnosis of prostate cancer through a systematic review and meta-analysis of 54 studies. Urinary PCA3 with a cutoff score of 35 had 71% pooled sensitivity and 68% pooled specificity. Urinary PCA3 is a noninvasive biomarker that can be used to aid in the diagnosis of prostate cancer. Purpose: To explore the diagnostic accuracy of prostate cancer antigen 3 (PCA3) test for the diagnosis of prostate cancer in this systematic review and meta-analysis. Patients and Methods: A systematic literature search of Medline, Embase, and Cochrane Library databases up to October 2019 was performed. The sensitivity, specificity, and diagnostic odds ratio with 95% confidence intervals (CIs) were calculated. The summary receiver operator characteristic graph came from individual studies. We also conducted metaregression analysis to identify the moderated factors. Results: Across 54 studies (17,575 patients), the pooled sensitivity, specificity, and diagnostic odds ratio of PCA3 were 0.71 (95% CI, 0.67-0.74), 0.68 (95% CI, 0.63-0.74), and 5.28 (95% CI, 4.28-6.51), respectively. The area under the summary receiver operator characteristic curve was 0.75 (95% CI, 0.71-0.79). Conclusion: Pooled data indicated that the PCA3 test had moderate sensitivity and specificity in the diagnosis of prostate cancer. PCA3 could be used as a noninvasive method for the diagnosis of prostate cancer. (C) 2020 The Author(s). Published by Elsevier Inc.