PCA3 test for prostate cancer in Africa

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Published: 8 Dec 2015
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Dr Imane Abdellaoui Maane - Moroccan Foundation for Advanced Science, Innovation and Research

Dr Imane Maane talks to ecancertv at AORTIC 2015 about a lack of accurate prostate cancer screening facilities in Africa and Morocco in particular.

She argues for the PCA3 test to be implemented in Africa in combination with AMACR quantificationas it is cheap and effective.

My research project is the development of a new approach for prostate cancer molecular diagnosis. Why? Prostate cancer remains one of the most widespread and perplexing of all human malignancies worldwide. The early diagnosis of prostate cancer is based on a combination of two tests: the digital rectal examination and the PSA, the digital rectal examination and the determination of PSA in blood samples. In the case of elevated PSA or abnormal digital rectal examination the patients were directed to biopsies. Biopsy is an important step in prostate cancer diagnosis; although it is invasive can have a side effect and they often are non-representative results since prostate cancer is not detected in one third of patients with a high level of PSA. Repeat biopsy decision is another challenge for clinicians since the patients with a high level of PSA are directed to a second series of biopsies which increase the unnecessary biopsy. So it’s important to develop the process for reliable results and to avoid an aggressive approach.

Why is this important?

In this organ in the last years a number of markers involved in prostate cancer have been identified to highlight their clinical value and establish a diagnosis; the prostate cancer antigen 3 is one of the most described one. PCA3 is detectable in urine samples and it’s the lead test in urine samples. While this test is available in 83 laboratories worldwide but in Africa and Morocco there is no laboratory. In this case to perform the test subcontracting with certificated laboratories is necessary and the cost of analysis remains very high and it’s so inaccessible for a large segment of the population from a disadvantaged area.

Overall, current diagnostic techniques show three problems. The first problem is and over-diagnosis and the cost of diagnosis is very high which needs to improve all the process. Based on this fact the aim of this project is to develop the first Moroccan and African kit for prostate cancer molecular diagnosis with lower costs to improve diagnosis with a lower cost. chemical results and for diagnosis results. In this sense we tested two genes, PCA3 and to improve the sensitivity and specificity in the first biopsies because there are no single markers with that can definitely assert to cap diagnosis. The used technology was the quantitative real time PCR to explore differential expression of PCA3 and in both urine and the biopsy samples. This method is reliable, accurate and with a low cost and improves sensitivity and specificity to quantify mRNA transcription in biological samples. Our study provides clear evidence that the combination of PCA3 and quantification in using PCR increases both sensitivity and specificity of prostate cancer diagnosis and may improve diagnosis in both urine samples and biopsies.

Your findings indicate that this new method works. What’s next?

The test is in the first stage and we will be validated internationally to commercialise a diagnosis kit for prostate cancer in the first biopsies because first biopsies is the major problem of prostate cancer and may develop a new test in urine samples for a non-invasive approach.