RESUMO
PURPOSE: Preclinical evaluation of PCA3 and AMACR transcript simultaneous detection in urine to diagnose clinical significant prostate cancer (prostate cancer with Gleason score ≥7) in a Russian cohort. PATIENTS AND METHODS: We analyzed urine samples of patients with a total serum PSA ≥2 ng/mL: 31 men with prostate cancer scheduled for radical prostatectomy, 128 men scheduled for first diagnostic biopsy (prebiopsy cohort). PCA3, AMACR, PSA and GPI transcripts were detected by multiplex reverse transcription quantitative polymerase chain reaction, and the results were used for scores for calculation and statistical analysis. RESULTS: There was no significant difference between clinically significant and nonsignificant prostate cancer PCA3 scores. However, there was a significant difference in the AMACR score (patients scheduled for radical prostatectomy p=0.0088, prebiopsy cohort p=0.029). We estimated AUCs, optimal cutoffs, sensitivities and specificities for PCa and csPCa detection in the prebiopsy cohort by tPSA, PCA3 score, PCPT Risk Calculator and classification models based on tPSA, PCA3 score and AMACR score. In the clinically significant prostate cancer ROC analysis, the PCA3 score AUC was 0.632 (95%CI: 0.511-0.752), the AMACR score AUC was 0.711 (95%CI: 0.617-0.806) and AUC of classification model based on the PCA3 score, the AMACR score and total PSA was 0.72 (95%CI: 0.58-0.83). In addition, the correlation of the AMACR score with the ratio of total RNA and RNA of prostate cells in urine was shown (tau=0.347, p=6.542e-09). Significant amounts of nonprostate RNA in urine may be a limitation for the AMACR score use. CONCLUSION: The AMACR score is a good predictor of clinically significant prostate cancer. Significant amounts of nonprostate RNA in urine may be a limitation for the AMACR score use. Evaluation of the AMACR score and classification models based on it for clinically significant prostate cancer detection with larger samples and a follow-up analysis is promising.
RESUMO
This study assessed the epidemiology of bladder cancer in Russia. The available publications in Russian were analysed, as well as information from the database of N. N. Blokhin Cancer Research Center, accumulating non-uniform data from different cities and regions of Russia. In 2006 there were 68 129 patients with bladder cancer in Russia, accounting for 2.8% of all cancer cases, with unknown proportions of males and females. In the same year 11 973 new bladder cancer cases were diagnosed, with morphological confirmation in 82.3% of cases. From 1999 to 2004 the incidence of bladder carcinoma increased by 5.3% in males and by 12.5% in females. In 2006 57.4% of patients with newly diagnosed disease were staged as T1 and T2, 26.8% as T3 and 11.4% as T4 bladder cancer cases. The mortality rate of patients with bladder carcinoma increased by 10.9% in males from 1999 to 2004 and did not change in females. In conclusion, over the past 10 years both the prevalence and incidence of bladder carcinoma have increased in Russia. There was a trend towards detecting less advanced cases of the disease, and stages T3 and T4 are diagnosed less frequently today than in 1996. As a result the mortality rate of bladder cancer patients within the first year from diagnosis has decreased, although the overall mortality rate in males has risen.