PSA density as a parameter in prostate biopsy decision of patients with prostate sized 80 mL or larger

Authors

  • Caner Ediz Department of Urology, Sultan Abdulhamid Han Education and Research Hospital, Istanbul, Turkey
  • Serhan Cimen Department of Urology, Malatya Education and Research Hospital, Istanbul, Turkey
  • Serkan Akan Department of Urology, Sultan Abdulhamid Han Education and Research Hospital, Istanbul, Turkey
  • Muhammed Cihan Temel Department of Urology, Sultan Abdulhamid Han Education and Research Hospital, Istanbul, Turkey
  • Omer Yilmaz Department of Urology, Sultan Abdulhamid Han Education and Research Hospital, Istanbul, Turkey
  • Ozlem Koksal Department of Biostatistics, Sultan Abdulhamid Han Education and Research Hospital, Istanbul, Turkey

DOI:

https://doi.org/10.18203/2320-6012.ijrms20190948

Keywords:

High prostate volume, Prostate biopsy, PSA density

Abstract

Background: Patients with high prostate volume (>80 ml) and high PSA levels make it difficult to decide on prostate biopsy. In this study, author aimed to detect of predictive factors to distinguish malignant or benign prostatic lesions in patients with prostate size over 80 ml.

Methods: A total of 299 patients underwent TRUSBP at the clinics between 2012-2017. Cases with prostate volume over 80 ml were divided into groups according to the pathology by benign (group 1) or malign (group 2). Author evaluated the predictive factors in two groups. Patient’s age, grading and findings of digital rectal examination, prostate volume, number of received cores, total (tPSA) and free PSA (fPSA) before biopsy, rate of percentage of free to total prostate specific antigen (f/tPSA) and PSA density was compared in both groups.

Results: Benign prostate hyperplasia was detected in 217 patients (72.58%) and prostate adenocarcinoma was detected in 82 patients (27.42%). The patient’s age, tPSA, fPSA and PSA density were 63.81 years, 9.71 ng/ml, 1.78 ng/ml and 0.10 g/ml2 in group 1 and 69.10 years, 38.32 ng/ml, 5.86 ng/ml and 0.42 ng/ml2 respectively. Patient’s age, tPSA, fPSA and PSA density was statistically significant between in two groups (p<0,05). Number of received cores and rate of f/tPSA were 14.02-13.84% and 19.06-17.62% in group 1 and 2, respectively and was not statistically significant. In group 2, prostate adenocarcinoma was most common detected with Gleason score 4+3 in 21 of 82 patients (25.6%).

Conclusions: High prostate volume (>80 ml) has a significant influence in PSA values and results of the biopsy, PSA density is extremely important in performing prostate biopsy decisions.

References

Hodge KK, McNeal JE, Terris MK, Stamey TA. Random systematic versus directed ultrasound guided transrectal core biopsies of the prostate. J Urol. 1989;142(1):71-4.

Uzzo RG, Wei JT, Waldbaum RS, Perlmutter AP, Byrne JC, Vaughan D. The influence of prostate size on cancer detection. Urol. 1995;46(6):831-6.

Karakiewicz PI, Bazinet M, Aprikian AG, Trudel C, Aronson S, Nachabé M, et al. Outcome of sextant biopsy according to gland volume. Urol. 1997;49(1):55-9.

Kulkarni GS, Al-Azab R, Lockwood G, Toi A, Evans A, Trachtenberg J, et al. Evidence for a biopsy derived grade artifact among larger prostate glands. J Urol. 2006;175(2):505-9.

Epstein JI, Allsbrook Jr WC, Amin MB, Egevad LL, ISUP Grading Committee. The 2005 International Society of Urological Pathology (ISUP) Consensus Conference on Gleason Grading of Prostatic Carcinoma. Am J Surg Pathol. 2005;29(9):1228-42.

DeAntoni EP. Age-specific reference ranges for PSA in the detection of prostate cancer. Oncology (Williston Park). 1997;11(4):475-82.

Veneziano S, Pavlica P, Querzè R, Viglietta G, Trenta A. Importance of specific prostatic antigen to prostatic volume ratio in the selection of patients for ultrasonography-guided biopsy of the prostate. Radiol Med. 1991;81(6):857-60.

Demura T, Takada T, Shimoda N, Hioka T, Iwaguchi Y, Ichihara S, et al. Mechanism underlying the negative effect of prostate volume on the outcome of extensive transperineal ultrasound-guided template prostate biopsy. Cancer Med. 2018;7(2):336-43.

Coban S, Doluoglu OG, Keles I, Demirci H, Turkoglu AR, Guzelsoy M, et al. Age and total and free prostate-specific antigen levels for predicting prostate volume in patients with benign prostatic hyperplasia. Aging Male. 2016;19(2):124-7.

Rubens DJ, Gottlieb RH, Maldonado Jr CE, Frank IN. Clinical evaluation of prostate biopsy parameters: gland volume and elevated prostate-specific antigen level. Radiol. 1996;199(1):159-63.

Luan Y, Huang TB, Gu X, Zhou GC, Lu SM, Tao HZ, et al. Effect of prostate volume on the peripheral nerve block anesthesia in the prostate biopsy: A strobe-compliant study. Medicine (Baltimore). 2016;95(28):e4184.

Yoon BI, Shin TS, Cho HJ, Hong SH, Lee JY, Hwang TK, et al. Is it effective to perform two more prostate biopsies according to prostate-specific antigen level and prostate volume in detecting prostate cancer? Prospective study of 10-core and 12-core prostate biopsy. Urol J. 2012;9(2):491-7.

Aganovic D, Prcic A, Kulovac B, Hadziosmanovic O. Influence of the prostate volume, prostate specific antigen density and number of biopsy samples on prostate cancer detection. Med Archives. 2012 Jan 1;66(1):41.

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Published

2019-02-27

How to Cite

Ediz, C., Cimen, S., Akan, S., Temel, M. C., Yilmaz, O., & Koksal, O. (2019). PSA density as a parameter in prostate biopsy decision of patients with prostate sized 80 mL or larger. International Journal of Research in Medical Sciences, 7(3), 914–917. https://doi.org/10.18203/2320-6012.ijrms20190948

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Original Research Articles