The Efficacy of 12-Site Biopsy Protocol in Men with Elevated Serum Prostate-Specific Antigen Level Only.
- Author:
Hyoung Keun PARK
1
;
Seok Soo BYUN
;
Dong Wan SOHN
;
Sung Kyu HONG
;
Eunsik LEE
;
Sang Eun LEE
;
Hak Jong LEE
Author Information
1. Departments of Urology, Seoul National University College of Medicine, Seoul, Korea. ssbyun@snubh.org
- Publication Type:Original Article
- Keywords:
Biopsy;
Prostate;
Prostate specific antigen
- MeSH:
Biopsy*;
Humans;
Male;
Prostate;
Prostate-Specific Antigen*;
Prostatic Neoplasms;
Ultrasonography
- From:Korean Journal of Urology
2005;46(5):463-466
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
Purpose: We evaluated the improvement in the rate of prostate cancer detection with the use of an extensive 12-site biopsy protocol in patients with only an elevated level of serum prostate-specific antigen (PSA). Materials and Methods: A total of 109 men with elevated PSA levels between 3 and 20ng/ml, but with no abnormal finding on digital rectal and transrectal ultrasound examinations, received transrectal ultrasound- guided prostate biopsies, which were performed at 12 sites, including the routine sextant and 6 far lateral regions (lateral apex, mid-lobe and base). The improvement in the detection rate was assessed according to the PSA level and prostate volume. Results: The mean age and PSA level of the patients were 63.5 8.6 years and 7.0 3.7ng/ml, respectively. Twenty-eight (25.7%) out of 109 men were diagnosed with prostate cancer. A traditional sextant biopsy detected 19 (67.9%) of the 28 prostate cancer patients, while 9 (32.1%) cancers were detected in the lateral region only. Overall, this extensive protocol resulted in a significant improvement, 8.3% (17.4 to 25.7%), in the detection rate (p=0.032). The improvement in men with a PSA of 10 ng/ml or less was 8.1% (14.0% to 22.1%, p=0.007) and in those with a PSA greater than 10 ng/ml the improvement was 8.7% (30.4% to 39.1%, p=0.162). The improvement in men with a prostate volume of 50cc or less was 8.0% (22.3% to 30.3%, p=0.083) and in those with a prostate volume greater than 50cc this was 9.1% (6.1% to 15.2%, p=0.043). Conclusions: The twelve-site biopsy protocol is a more efficient method in men with a PSA and prostate volume of 10ng/ml or less and greater than 50cc, respectively, compared to the sextant protocol.
