Mehmet Nuri BODAKÇI, Yaşar BOZKURT, Murat ATAR, Namık Kemal HATİPOĞLU, Necmettin PENBEGÜL, Haluk SÖYLEMEZ, Ahmet Ali SANCAKTUTAR, Kadir YILDIRIM, Hüseyin BÜYÜKBAYRAM

Düşük prostat spesifik antijen değeri olan hastalara yapılan transrektal prostat biyopsi sonuçları

Amaç: Bu çalışmanın amacı, prostat spesifik antijen (PSA) değerleri 4 ng/ml altında olan hastaların prostat biyopsi sonuçlarını değerlendirmektir. Gereç ve yöntem: Kliniğimizde Ocak 2005-Aralık 2011 tarihleri arasında prostat kanseri şüphesi olan ve total PSA değeri 4 ng/ml’nin altında olan 61 hastadan alınan prostat biyopsisinin sonuçları retrospektif olarak değerlendirildi. Bulgular: Yaşları 41 ile 74 arasında değişen ve PSA ortalaması 2.5 ng/ml olan 63 olguya Transrektal Ultrasonografi (TRUS) eşliğinde prostat biyopsisi yapıldı. On iki hastada (%19) prostat kanseri tespit edildi. Biyopsi sonucu prostat kanseri olan bu hastaların ortalama Gleason skoru 6.8 (5-7), tümor pozitif kor sayısı ise 3 idi. Sonuç: Prostat spesifik antijen değeri 4 ng/ml’nin altında olan olgularda kanser oranımız %19 olup, önceki raporlarla uyumlu bulunmuştur.

The results of transrectal prostate biopsy in patients with low levels of prostate specific antigen

Objectives: The aim of this study is to evaluate the results of prostate biopsy of patients who had the prostate-specific antigen (PSA) levels below 4 ng/ml. Material and methods: The medical records of 63 patients who underwent transrectal prostate biopsy, between January 2005 and December 2011, due to suspicion of prostate cancer with the PSA levels under 4 ng/ml were retrospectively reviewed. Results: Transrectal Prostate biopsy was performed to 63 patients. Prostate cancer was detected in 12 (19%) patients. The mean value of PSA was 2.5 ng/ml. The Gleason score of Prostate cancer patients was 6,8 (5-7) and the number of positive cores were 3. Conclusions: The rate of prostate cancer was found as 19% in patients with levels of PSA under 4 ng/ml and this ratio is compatible with the results of previous reports.

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1. Boyle P, Ferlay J. Cancer incidence and mortality in Europe, 2004. Ann Oncol 2005; 16(3):481-88.
2. Jemal A, Siegel R, Ward E, et al. Cancer statistics, 2008. CA Cancer J Clin 2008; 58(1):71-96.
3. Heidenreich A, Bellmunt J, Bolla M, et al. EAU guidelines on prostate cancer. Part 1: screening, diagnosis, and treatment of clinically localised disease. European urology 2011; 59(1):61-71.
4. Cooner WH, Mosley BR, Rutherford CL, Jr., et al. Prostate cancer detection in a clinical urological practice by ultrasonography, digital rectal examination and prostate specific antigen. J Urol 1990; 143(8):1146-52.
5. Catalona WJ, Smith DS, Ratliff TL, et al. Detection of organconfined prostate cancer is increased through prostate-specific antigen-based screening. JAMA 1993; 270(7):948-54.
6. Mettlin C, Lee F, Drago J, et al. The American Cancer Society National Prostate Cancer Detection Project. Findings on the detection of early prostate cancer in 2425 men. Cancer 1991; 67(11):2949-58.
7. Colberg JW, Smith DS, Catalona WJ. Prevalence and pathological extent of prostate cancer in men with prostate specific antigen levels of 2.9 to 4.0 ng./ml. J Urol 1993; 149(3):507-09.
8. Lodding P, Aus G, Bergdahl S, et al. Characteristics of screening detected prostate cancer in men 50 to 66 years old with 3 to 4 ng./ml. Prostate specific antigen. J Urol 1998; 159(6):899-903.
9. Catalona WJ, Smith DS, Ratliff TL, et al. Measurement of prostate-specific antigen in serum as a screening test for prostate cancer. N Engl J Med 1991; 324(9):1156-61.
10. Schroder FH, van der Cruijsen-Koeter I, de Koning HJ, et al. Prostate cancer detection at low prostate specific antigen. J Urol 2000; 163(6):806-12.
11. Carter HB, Pearson JD. Prostate-specific antigen testing for early diagnosis of prostate cancer: formulation of guidelines. Urology 1999; 54:780-6.
12. Catalona WJ, Hudson MA, Scardino PT, et al. Selection of optimal prostate specific antigen cutoffs for early detection of prostate cancer: receiver operating characteristic curves. J Urol 1994; 152(11):2037-42.
13. Ross KS, Carter HB, Pearson JD, et al. Comparative efficiency of prostate-specific antigen screening strategies for prostate cancer detection. JAMA 2000; 284(8):1399-405.
14. Morgan TO, Jacobsen SJ, McCarthy WF, et al. Age-specific reference ranges for prostate-specific antigen in black men. N Engl J Med 1996; 335(2):304-10.
15. Altunoluk B, Bahar MR, Eren M, et al. Evaluation of the role of digital rectal examination and prostate specific antigen in diagnosis of prostate cancer J Clin Exp Invest 2012; 3(1):66-70.
16. Catalona WJ, Smith DS, Ornstein DK. Prostate cancer detection in men with serum PSA concentrations of 2.6 to 4.0 ng/mL and benign prostate examination. Enhancement of specificity with free PSA measurements. JAMA 1997; 277:1452-55.
17. Gilbert SM, Cavallo CB, Kahane H, et al. Evidence suggesting PSA cutpoint of 2.5 ng/mL for prompting prostate biopsy: review of 36,316 biopsies. Urology 2005; 65(3):549-53.
18. Thompson IM, Pauler DK, Goodman PJ, et al. Prevalence of prostate cancer among men with a prostate-specific antigen level _____ or =4.0 ng per milliliter. N Engl J Med 2004; 350(10):2239-46.
19. Thompson IM, Ankerst DP, Chi C, et al. Operating characteristics of prostate-specific antigen in men with an initial PSA level of 3.0 ng/ml or lower. JAMA 2005; 294(1):66- 70.
20. Leite KR, Srougi M, Dall’Oglio MF, et al. Histopathological findings in extended prostate biopsy with PSA _____ or = 4 ng/mL. Int Braz J Urol 2008; 34(3):283-90.