Title: Total PSA, digital rectal examination, ultrasonography, and PSA density as criteria for prostate biopsy request
Abstract: Introduction: The widespread use of the prostate specific antigen (PSA) has largely improved the early diagnostics of the prostate carcinoma. However, the prostate biopsy remains the most accurate method for diagnostics of the disease.
The aim of this study was to elucidate the criteria for requesting a prostate biopsy in patients with symptoms on lower urinary tract and concomitant finding of enlarged prostate, measured by ultrasound (prostate volume greater than 25ccm).
Methods: In the study were included 35 patients with symptoms on lower urinary tract who were on their first visit to the urologist, further diagnosed with benign prostate hyperplasia. The diagnosis was confirmed by a negative result from the biopsy.
We have analyzed the PSA values (Total PSA), the findings of digital rectal examination (DRE) and the PSA density {PSA (ng/mL) /prostate volume (ccm)}.
Results: One of the patients had PSA value lower than 4ng/mL, 16 of them were in the “grey” zone, and 18 had PSA values above 10ng/mL. Regarding the DRE findings, 3 patients had normal result, whereas the rest of 32 were suspect. In contrast to PSA and DRE, the results for PSA density showed the following: 15 patients had PSA density of up to 0,15, which is considered as a cut-off value and a normal result, and 20 patients had PSA density of more than 0,15.
Discussion: From these results we conclude that PSA density can discriminate between benign prostate hyperplasia and prostate carcinoma better than PSA and DRE, and its use could reduce the number of negative biopsies.
Publication Year: 2012
Publication Date: 2012-09-19
Language: en
Type: article
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