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Microarray-based Identification of Individual HERV Loci Expression: Application to Biomarker Discovery in Prostate Cancer
Published on: November 2, 2013
Is prostate biopsy essential to diagnose prostate cancer in the older patient with extremely high prostate-specific
Jee Young Jang1, Young Sig Kim
1Department of Urology, Urological Science Institute, Yonsei University Health System, Seoul, Korea.
Purpose:
The results of all prostate biopsies may be positive and suggestive of adenocarcinoma in patients with prostate-specific antigen (PSA) values higher than 100 ng/ml. We considered that the prostate cancer in patients with high PSA might be advanced disease and therefore that the treatment strategy should not be changed according to pathological reports. Thus, we assessed the role of prostate biopsy when diagnosing prostate cancer in patients with extremely high PSA levels.
Materials And Methods:
We reviewed the records of 1,150 cases undergoing prostate biopsies. Patients with urinary tract infection and acute urinary retention were excluded. According to the pre-biopsy PSA level, patients were divided into 6 groups (group A, 4 to 20 ng/ml; B, 20 to 40 ng/ml; C, 40 to 60 ng/ml; D, 60 to 80 ng/ml; E: 80 to 100 ng/ml; and F, above 100 ng/ml).
Results:
The calculated positive predictive value (PPV) for prostate cancer was 22% in group A, 54% in group B, 73% in group C, 75% in group D, 89% in group E, and 100% in group F, respectively. Pathological diagnosis was adenocarcinoma in all patients in group F (n=56). Among them, 38 patients (67.9%) had lymph node metastasis or extra-prostatic disease or both and 43 patients (76.8%) had bony metastasis. In group F, all cases were advanced prostate cancer (stage III or IV). All of them received hormonal therapy following diagnosis.
Conclusions:
We suggest the possibility for biopsy-free diagnosis of prostate cancer in patients with extremely high levels of serum PSA and evidence of advanced disease in imaging studies, especially in older patients with comorbid medical problems.
