Histopathological findings in extended prostate biopsy with PSA ≒ 4 ng/mL

作者：Leite; Katia R; Srougi; Miguel; Dall' Oglio; Marcos F; Sanudo; Adriana; Camara Lopes; Luiz H

来源：International Brazilian Journal of Urology, 2008.

DOI：10.1590/S1677-55382008000300005

• psa
• prostate cancer
• biopsy
• diagnosis
• gleason score
• tumor volume.

objective: cancer detection has been reported in up to 27% of patients when lowering the psa cutoff to 2.5 ng/ml. although this practice could increase the number of biopsies performed, it also could lead to more frequent detection of significant prostate cancers at an organ-confined stage and/or a less aggressive state. this study describes the incidence of malignancy and tumor characteristics in extended prostate biopsies with psa ≒ 4 ng/ml. materials and methods: prostate biopsies from 1081 patients where examined, 275 (25.4%) patients had psa level ≒ 4 ng/ml. results: cancer was diagnosed in 32.0% and 35.7% of patients with psa ≒ 4 ng/ml and %26gt; 4 ng/ml, respectively (p = 0.906). the median gleason score was 7 independent of psa %26gt; or ≒ 4 ng/ml (p = 0.078). the median number of cores positive for tumor was 4 and 3, respectively, for psa %26gt; 4 ng/ml and psa ≒ 4 ng/ml (p = 0.627). there was a difference in the total percent of tumors involving all cores, 11% and 7% for psa %26gt; or ≒ 4 ng/ml (p = 0.042). fifty-six patients underwent radical prostatectomy, 12 had psa ≒ 4 ng/ml. in both groups, a diagnosis of cancer was accurate with no differences in gleason score, tumor volume or staging for both groups. conclusion: when psa is below 4 ng/ml, cancer is detected in a proportion equal to the proportion diagnosed with a psa %26gt; 4 ng/ml, and tumor characteristics are similar between the two groups. only clinically significant tumors were diagnosed following radical prostatectomy.