OBJECTIVES:
To analyze the efficiency of the routinary application of the DD3PCA3 gene (PCA3), prior to performing second prostatic biopsies in patients with suspected prostatic carcinoma.
MATERIAL AND METHODS:
From the database of patients who underwent a prostate biopsy at the Hospital Complex of Cáceres over 2 years (n = 202), patients who underwent a second prostate biopsy were selected. These patients are given the ideal cost of performing the PCA3, together with the percentage according to the literature of biopsies to which this marker would indicate to repeat the biopsy (35-67%). These results are compared with the cost in euros of performing second prostate biopsies per protocol without prior use of PCA3.
RESULTS:
The cost of performing 42 prostate biopsies is 115,197.18 euros in 2 years. Assuming the cost of PCA3 and the minimum percentage of biopsies saved according to previous data, 35% of biopsies saved with its use, the value would be 97,498.107 euros. The savings with the application of this marker in this population would be 17,699.07 euros, with a percentage of 15.36%. Assuming the arithmetic mean in biopsies saved of 51%, the value would be 79,066.55 euros. The savings with the use of the marker would be 36,130.62 euros and the percentage of 31.36%.
DISCUSSION:
PCA3 is a non-coding RNA whose gene is located in Cr9q21-22. It is organ specific and its median expression is 66-fold greater in 95% of prostate cancer tissue analyzed versus normal tissue or benign prostatic hyperplasia. Its expression is detected in 30 ml of urine collected after a rectal examination with 3 centripetal expressions per lobe from lateral to midline. The literature offers a sensitivity range of 46.9% -82.3% in PCA3, providing a biopsy saving rate of 35-67%. Applying this percentage to our database we obtained a cost savings with the use of this marker.
CONCLUSIONS:
The routine use of the PCA3 marker prior to the repetition of second prostate biopsies results in a minimum monetary saving of 15.36%, in the sample selected over 2 years.
