Clinical value of prostate specific antigen based parameters for the detection of prostate cancer on repeat biopsy: The usefulness of complexed prostate specific antigen adjusted for transition zone volume

Minoru Horinaga, Jun Nakashima, Midori Ishibashi, Mototsugu Oya, Takashi Ohigashi, Ken Marumo, Masaru Murai

Research output: Contribution to journalArticle

12 Citations (Scopus)

Abstract

Purpose: To our knowledge the indications for repeat prostate needle biopsy in men whose previous transrectal ultrasound guided biopsy results revealed no evidence of cancer have not yet been defined. We identified the most effective method for detecting prostate cancer on repeat biopsy. Materials and Methods: One or more systematic repeat prostate biopsies were performed in 144 consecutive patients, including 86 with prostate specific antigen (PSA) levels between 4 and 10 ng./ml. at repeat biopsy. Men in whom cancer was detected on repeat biopsies were compared with their counterparts in terms of digital rectal examination findings, PSA based parameters and an atypical prostate on initial prostate biopsy. Results: Prostate cancer was detected on repeat biopsy in 39 of the 144 patients and in 19 on subset analysis of 86. Serum PSA levels at repeat biopsy did not differ significantly in patients with and without prostate cancer. According to receiver operating characteristics analysis the α1-antichymotrypsin-PSA complex adjusted for transition zone volume had the greatest area under the curve values, that is 0.756 for all 144 patients and 0.768 for the subset analysis of 86. Multiple logistic regression analysis of the subset of 86 patients showed that α1-antichymotrypsin-PSA complex adjusted for transition zone volume was the only significant independent predictor of cancer. Conclusions: α1-Antichymotrypsin-PSA complex adjusted for transition zone volume was the most powerful predictor of cancer in men who had undergone previous negative prostate biopsies. This parameter may be used to avoid more unnecessary repeat biopsies with an acceptable decrease in sensitivity.

Original languageEnglish
Pages (from-to)986-990
Number of pages5
JournalJournal of Urology
Volume168
Issue number3
DOIs
Publication statusPublished - 2002 Sep

Keywords

  • Biopsy
  • Prostate
  • Prostate-specific antigen
  • Prostatic neoplasms

ASJC Scopus subject areas

  • Urology

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