Clinical Value of Prostatic Biopsy in Patients with Elevated Serum PSA

Choi, Jae Hong; Park, Heung Jae; Kwon, Chil Hun

Abstract

We analyzed the results of the prostate biopsies of 64 patients with elevated serum PSA (>4ng/ ml) at Kangbuk Samsung Hospital from March 1993 to February 1996. Of 64 patients, 11 patients (17%) had prostate cancer and 53 patients (83%) were diagnosed as benign prostatic hyperplasia. Among the patients with prostate cancer, 1 patient had serum PSA between 4.1 to 10.0ng/ml, 2 patients between 10.1 to 20.0ng/ml and 8 patients above 20ng/ml The detection rates of prostate cancer in each serum PSA levels were 3%, 15% and 36% respectively. Two of 17 patients with both negative DRE and TRUS were diagnosed as prostate cancer Two of 21 patients with positive TRUS and negative DRE had prostate cancer but none of 8 patients with positive DRE and negative TRUS had prostate cancer. Seven of 18 patients with both positive TRUS and DRE had prostate cancer. The sensitivity, specificity, positive predictive value and overall accuracy of DRE and TRUS in patients with elevated PSA (>4ng/m1) were 64%, 64%, 27%, 64% and 82%, 43%, 23%, 50% respectively in patients with elevated serum PSA (>4ng/ml). In conclusion, these results suggest that prostate biopsy in early diagnosis of prostate cancer would be needed for the patients with elevated serum PSA (>4ng/ml) regardless of the results of DRE and TRUS.