Study of prostatic specific antigen versus prostatic biopsy in the diagnosis of prostatic diseases

ABSTRACT

The majority [60 to 65%] of patients undergoing prostate needle biopsies for abnormal PSA and/or digital rectal examination will not have adenocarcinoma on pathological examination. Benign prostatic hyperplasia [BPH] and prostatitis are causes of PSA elevation. We elected to evaluate the distribution of malignant and non-malignant conditions in patients undergoing prostate needle biopsies. Six hundred and fifty consecutive patients underwent 12 cores Trans rectal Ultrasound [TRUS] guided prostate needle biopsies. None had clinical prostatitis. Prostate volume was measured during the Trus. Pathological examination focused on the presence of normal prostate, BPH, prostatitis and cancer in every core. Patients were stratified into two groups [G] according to digital rectal examination [D. R. E] [G I Suspicious [+ve DRE], 500 patients or G II Normal [-ve D.R E], 150 patients. Prostatic volume ranged between 20-135 ml with a median of 43m1. The distribution of cancer, prostatitis, BPH, and abscess on pathology were 177 pts [27%] with a median volume of 36m1, 130 pts [20%] with median volume of 59m;, 307 pts [47.5%] with a median volume of 42ml. and 36 pts [5.5%] with a median volume of 51ml respectively. The majority of pathology on biopsy in patients with suspected prostate cancer is nonmalignant with EPH. Being the most common [47.5%] and prostatitis a significant finding [20%]. Prostatic volume was not a factor in predicting outcome, Except for prostatitis, as expected the higher the PSA, the higher the incidence of prostate cancer