Free PSA/total PSA ratio increases the detection rate of prostate cancer in twelve-core biopsy

Urol Int. 2009;82(3):280-5. doi: 10.1159/000209358. Epub 2009 May 11.

Abstract

Background: In the present study, we compared 12- with 8-core biopsy in patients with prostate-specific antigen (PSA) levels of 4.0-20.0 ng/ml. We also examined whether the free/total (F/T) PSA ratio is useful for cancer detection in 12-core biopsy.

Methods: A total of 419 men with PSA level between 4.0 and 20.0 ng/ml underwent transrectal ultrasound-guided transperineal needle biopsies of the prostate. Of these men, 235 underwent 8-core biopsy and 184 underwent 12-core biopsy. We compared the cancer detection rate between the 8- and 12-core biopsy groups by analyzing the PSA value, and especially the F/T PSA ratio.

Results: The cancer detection rate in the 12-core group (35.9%) was significantly higher than in the 8-core group (23.8%). In cases of PSA level of 4.0-20.0 ng/ml with F/T PSA ratio less than 0.11, the cancer detection rate was 53.1% in the 12-core biopsy group. Performing 12-core biopsy resulted in a marked difference of cancer detection rate between men with F/T PSA ratio less than 0.11 and those with more than 0.12 in gray zone PSA (48.2% and 17.5%, respectively).

Conclusions: Twelve-core biopsy can achieve a higher detection rate of prostate cancer than 8-core biopsy using F/T PSA ratio.

Publication types

  • Comparative Study

MeSH terms

  • Aged
  • Biopsy, Needle* / methods
  • Humans
  • Male
  • Middle Aged
  • Neoplasm Staging
  • Predictive Value of Tests
  • Prostate-Specific Antigen / blood*
  • Prostatic Neoplasms / diagnosis*
  • Prostatic Neoplasms / immunology
  • Prostatic Neoplasms / pathology
  • ROC Curve
  • Ultrasonography, Interventional

Substances

  • Prostate-Specific Antigen