Cemil YAĞCI, Sadettin KÜPELİ, Ahmet Tuncay TURGUT, Çağatay GÖĞÜŞ, Eriz ÖZDEN

Diagnostic value of transrectal ultrasonography in patients with PSA values >20 ng/ml

AMAÇ: Prostat spesifik antijen (PSA) değeri 20 ng/ml 'nin üzerindeki hastalarda transrektal ultrasonografinin (TRUS) prostat glandında kanserli bölgelerin belirlenmesine yönelik değerinin araştırılması amaçlanmıştır. GEREÇ VE YÖNTEM: PSA değerşeri 20 ng/ml 'nin üzerinde olan ve TRUS eşliğinde prostat biyopsisi uygulanan 51 hasta çalışmaya dahil edilmiştir. TRUS eşliğinde 6 kadran sistematik biyopsiye ek olarak lezyon biyopsileri alınmıştır. Biyopsi alınan her odağın TRUS bulguları ile histopatolojik sonuçları karşılaştırılmıştır. BULGULAR: 408 biyopsi odağının analizine göre TRUS 'un sensitivite, spesifisite, pozitif ve negatif prediktivite değerleri sırasıyla; 63.5%, 90.4%, 83.7% ve 76.2% bulunmuştur. Tüm çalışma grubunda 51 hastanın 4 'ünde (%7.84) TRUS 'da şüpheli bulgu olmamasına rağmen biyopside prostat kanseri saptanırken, 9 hastada (%17.64) kanser TRUS 'da belirtilen lezyondan farklı tarafta saptanmıştır. Ek olarak, 65 (%15.9) lokalizasyonda TRUS ile saptanan lezyon olmamasına rağmen biyopsi ile kanser saptanmıştır. SONUÇ: TRUS 'un diagnostik değeri 20 ng/ml üzerindeki PSA değerlerinde bile yeterince yüksek değildir. Bu nedenle, PSA değeri 20 ng/ml üzerindeki hasta grubunda da lezyon biopsilerine ek olarak sistematik biyopsilerin alınması gereklidir.

PSA değeri 20 ng/ml üzerindeki hastalarda transrektal ultrasonografi'nin tanı değeri

PURPOSE: We aimed to evaluate the value of transrectal ultrasonography (TRUS) for the determination of the cancer sites within the prostate gland in patients with prostate-specific antigen (PSA) values >20 ng/ml. MATERIALS AND METHODS: Fifty-one patients with PSA values > 20 ng/ml who underwent TRUS examination and TRUS-guided prostate biopsy were included to the study. Under TRUS guidance sextant plus lesion biopsies were taken from each patient. TRUS findings of each biopsy location were correlated with histopathological outcome. RESULTS: In the analysis of 408 biopsy foci, sensitivity, specificity, positive and negative predicitive values of TRUS were 63.5%, 90.4%, 83.7% and 76.2% respectively. In total, 4 of 51 (7.84%) patients with nonsuspicious TRUS findings had prostate cancer, whereas there were nine (17.64%) patients with cancer foci determined at the contralateral side of the lesion detected by TRUS. In addition, there were 65 (15.9%) locations in which cancer foci were identified altough TRUS detected no lesion. CONCLUSIONS: Diagnostic value of TRUS is not sufficiently high, even in PSA ranges > 20 ng/ml. Therefore, we suggest that systematic biopsies should also be performed in patients with PSA > 20 ng/ml in addition to the lesion biopsies.

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