Noninvasive PCA3 detection for screening prostate diseases using a graphene oxide-based method

Prostate Cancer Associated 3 (PCA3) as a promising biomarker to replace serum prostate-specific antigen (PSA) for differential diagnosis of benign and malignant prostate diseases. However, the detection of PCA3 in urine requires the collection of digital rectal examination (DRE) urine, which limits the application of PCA3 in screening prostate diseases. In the present study, a new reverse transcription quantitative real-time polymerase chain reaction (qRT-PCR) method was developed for PCA3 detection in non-DRE urine. The method uses the nanomaterial Graphene oxide (GO) to effectively prevent nonspecific amplification in qRT-PCR. GO-based qRT-PCR produced no nonspecific amplification. Receiver operating characteristic curve (ROC) results showed that the area under curve (AUC) of PCA3 to discriminate normal control subjects from prostate cancer (PCa) was 0.869 (95% confidence interval [CI], 0.689–1.000), and using 2.711 as the cutoff value of PCA3, the sensitivity was 81.8% and the specificity was as high as 88.9%. For prostatitis (PTIS) and PCa, the AUC value of PCA3 to distinguish them was 0.636 (95% CI, 0.396–0.877), with 81.8% sensitivity and 58.3% specificity. Compared with the 8.3% specificity of PAS, the specificity of PCA3 was improved by 50%, which suggested that PCA3, in non-DRE urine, has a significant potential application in the differential diagnosis of prostate diseases.