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    Korean J Urol. 2006 Jun;47(6):591-595. Korean.
    Published online Jun 30, 2006.
    https://doi.org/10.4111/kju.2006.47.6.591
    Copyright © 2006 The Korean Urological Association
    Original Article

    Comparative Analysis of the Prostate Cancer Detection Rate according to Region and Number of Biopsy in Patient with Elevated Serum PSA

    Heung Seok Ahn, Chil Hun Kwon and Kwan Joong Joo
      • Department of Urology, Sungkyunkwan University School of Medicine, Seoul, Korea.
    • Corresponding author (Email: urojoo@dreamwiz.com )
    Received February 13, 2006; Accepted April 22, 2006.

    Abstract

    Purpose

    We evaluated the rate of prostate cancer detection according to the region and number of biopsies in patients with an elevated level of serum prostate-specific antigen (PSA).

    Materials and Methods

    Transrectal ultrasound (TRUS) guided prostate biopsies were performed at 12 regions, using the standard sextant, with an additional 6 cores from the far lateral peripheral zone, in 178 men with an elevated PSA level, and with no suspicious lesions of prostate cancer on digital rectal examination (DRE) and TRUS. We analyzed the rate prostate cancer detection according to the region, number of biopsies, the PSA level, prostate volume and PSA density (PSAD).

    Results

    The rates of cancer detection were 12.9, 11.8 and 7.4% in the 12 core, lateral 6 core and medial 6 core (standard sextant) biopsies, respectively (p<0.05). There were no differences in overall cancer detection rates between 12 core and lateral 6 core plus apex medial 2 core biopsies (12.9%). In men with a PSA level greater than 20ng/ml, no difference in cancer detection was found with the 12 core or either of the 6 core biopsies (positive rate 33.3%). In men with a PSA level over 10ng/ml, a prostate volume less than 49cc or a PSAD greater than 0.15, a lateral 6 core biopsy made no difference to the diagnosis of prostate cancer compared to a 12 core biopsy.

    Conclusions

    A lateral 6 core biopsy, combined with an apex medial 2 core biopsy, is a more efficient method for the detection of prostate cancer than the standard sextant biopsy in men with an elevated serum PSA level without a suspicious lesion on DRE and TRUS.

    Keywords
    Prostatic neoplasms; Biopsy; Prostate-specific antigen

    Figures

    Fig. 1
    The coronal prostate plane, showing the 12 core biopsy scheme. Open and closed circles represent standard and lateral sextant sites, respectively.

    Tables

    Table 1
    Number of prostate cancers according to the number and site of cores (n=178)

    Table 2
    Cancer detection rate according to serum PSA level (ng/ml)

    Table 3
    Cancer detection rate according to the prostate volume (cc)

    Table 4
    Cancer detection rate according to the PSAD

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    MeSH Terms
    Biopsy*
    Diagnosis
    Digital Rectal Examination
    Humans
    Male
    Prostate*
    Prostate-Specific Antigen
    Prostatic Neoplasms*
    Ultrasonography
    Metrics
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