The widely used PSA blood marker is well established. However, the poor specificity of the PSA test for detecting cancer, or for differentiating indolent cancers from clinically significant ones, tends to lead to many negative biopsies and overtreatment of men with prostatic adenocarcinoma. More specific markers are being sought.PCA3 (formerly known as DD3) is one such marker. It is a prostate-tissue-specific, noncoding messenger RNA (mRNA) that is selectively overexpressed in virtually all prostate carcinoma specimens compared to normal prostate tissue. These attributes of PCA3 mRNA expression make it a promising prostate-cancer-specific marker. The potential of the prostate cancer antigen 3 (PCA3) urine assay to aid prostate cancer diagnosis and minimize unnecessary biopsies has been extensively studied. Results from three recent studies that compared the performance of PCA3 with PSA are promising but some issues remain. For example, it is not known what the most appropraite cutoff might be for optimal decision making for or against biopsy. At this time, it is not recommended by any guidelines to my knowledge.
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