Detection of Prostate Cancer from Serum Prostate Specific Antigen

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Objective: The results of a prostate biopsy performed on patients with a serum prostatespecific antigen (PSA) value above 4.0 ng/ml were analyzed for usefulness in detecting prostate cancer. We examined relationships between the results and the diagnosis rate, histological grade in atypism and clinical staging. Subjects and Methods: A total of 287 patients who had serum PSA values of 4.1 ng/ml or more underwent systematic sextant prostate biopsy under transrectal ultrasound (TRUS) guidance at our department of Urology from January 1998 to December 2001. Results: Cancer was detected at the initial biopsy in 88 of the 109 (80.7%) prostatic cancer patients. In the 21 patients, re-biopsy or light microscopic examination of the materials obtained from the transurethral resection (TUR-P) of the prostate revealed cancer. The positive rate in the initial biopsy was 30.7% (88/287) and, false negative rate was 10.6% (21/199). Many of the patients had low-grade and low-stage cancer. The cancer detection rate was 16.5% (18/109) in the gray zone. The incidence of prostate cancer was the highest in patients 61〜70 years old, being significantly older than the patients with benign prostate hyperplasia (BPH). The PSA value was significantly higher at a more advanced clinical stage, and in poorly differentiated cancer. Conclusion: The PSA value increased, in proportion to the clinical stage and the histological grading. Examinations using PSA-based markers and systematic biopsy of more sectors such as 8-core or 12-core biopsy including the transition zone (TZ) are necessary to further improve the prostate cancer detection rate, particularly in the gray zone.
愛知医科大学の論文
2003-12-15

Detection of Prostate Cancer from Serum Prostate Specific Antigen

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