PCA3 score prognostic value for identifying postoperative ISUP grades 4-5 in localized peripheral zone prostate cancer with a posterior tumor growth dominant pattern

At present, the identification of high-risk groups of localized prostate cancer (PCa) is highly relevant. Our previous research demonstrated that prostate cancer antigen 3 (PCA3) scores depend on the tumor zone of origin (TZO) and the tumor growth dominant pattern (TGDP). The aim: to assess the prognostic value of PCA3 score for identifying postoperative 4-5 grade group according to the International Society of Urological Pathology 2014 (ISUP) classification in patients with localized peripheral zone prostate cancer with posterior TGDP (pPZ-PCa). Materials and methods. PCA3 scores and correlations were assessed and compared in different PCa patient groups and subgroups based on TZO, TGDP, and ISUP grade. Receiver operating characteristic curve (ROC) analysis was used to evaluate the diagnostic significance of the model and determine the optimal PCA3 score cutoff for identifying ISUP 4-5. Results. The PCA3 scores showed a significant (p˂0.01) positive correlation (r=0.71) with ISUP grade in pPZ-PCa. PCA3 scores differed significantly (p<0.01) between ISUP 1-3 and 4-5 pPZ-PCa subgroups. ROC analysis demonstrated excellent performance with an AUC of 0.98 (95% CI: 0.95-0.99) for identifying ISUP 4-5 pPZ-PCa. Conclusions. PCA3 scores demonstrated prognostic value for identifying postoperative ISUP 4-5 in pPZ-PCa. The study was performed in accordance with the principles of the Declaration of Helsinki. The study protocol was approved by the Local Ethics Committee for all participants. The informed consent of the patient was obtained for conducting the studies. No conflict of interests was declared by the authors.