Is it Appropriate to Lower the Prostate Specific Antigen Cut-off Value to 2.5 ng/ml for Prostate Biopsy in Korean?.
- Author:
Byung Il YOON
1
;
Su Jin KIM
;
Hyuk Jin CHO
;
Sung Hoo HONG
;
Dong Wan SOHN
;
Ji Youl LEE
;
Tae Kon HWANG
;
Sae Woong KIM
Author Information
1. Department of Urology, Catholic University College of Medicine, Seoul, Korea. ksw1227@catholic.ac.kr
- Publication Type:Original Article
- Keywords:
Prostate cancer;
Prost-specific antigen;
Biopsy
- MeSH:
Biopsy;
Humans;
Neoplasm Grading;
Prostate;
Prostate-Specific Antigen;
Prostatic Neoplasms;
Retrospective Studies
- From:Korean Journal of Andrology
2009;27(3):212-216
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
PURPOSE: Currently many clinicians have recommendsprostate biopsy when the level of prostate specific antigen (PSA) is higher than 4.0 ng/ml. However, recently the prostate cancer detection rates werereported to be about 20% at PSA level 2.5 to 4.0 ng/ml. Therefore, an increasing amount of hospitals have recommends lowering the PSA cut off level to 2.5 ng/ml. We retrospectively evaluated the prostate cancer detection rate and pathologic characteristics of patients with PSA level of 2.5 to 4.0 ng/ml and we compared this with the patients who had PSA level in the range of 4.1 to 10.0 ng/ml. MATERIAL AND METHODS: We analyzed the data of 515 patients who received prostate biopsy in the range of PSA level 2.5 to 10 ng/ml. The clinical characteristics, cancer detection rate and pathologic findings of the biopsy were compared between the PSA 2.5-4.0 ng/ml group and PSA 4.1-10.0 ng/ml group. RESULTS: Cancer detection rates in patients who underwent biopsy were 18.1% and 22.4% at PSA 2.5 to 4.0 and 4.1 to 10.0 ng/ml, respectively. Mean Gleason scores were found 6.4+/-0.5 and 6.6+/-0.7 and high grade cancers with Gleason score 7 or more were found in 50% and 58.4% of patients with cancer with PSA 2.5 to 4.0 and 4.1 to 10.0 ng/ml, respectively. There were no significant difference between the 2 groups in cancer detection rates and pathologic findings on biopsy including mean Gleason score and high grade cancers with Gleason score 7 or more between two groups. CONCLUSION: There were no significant difference in cancer detection rates and pathologic findings between PSA 2.5-4 ng/ml group and PSA 4.1-10 ng/ml group. These results suggest that a lower PSA cutoff should be considered as an indication for prostate biopsy in the Korean population.
