Carral-Valdéz RA, Hernández-González M, Carrasco-Gutiérrez R, Manzanilla-García HA

Language: Spanish
References: 37
Page: 68-74
PDF size: 193.40 Kb.

ABSTRACT

Prostate cancer is the principal malignant neoplasia in men over 65 years of age in Mexico and is in second place in men between forty-five and sixty-four years of age. Since 1989 the ideal biopsy regimen to increase cancer detection and reduce false negative results has been sought.
Methods: An analytical cross-sectional study was carried out within the time frame of April 3, 2008 to October 3, 2008. One hundred forty-five patients underwent transrectal biopsy of the prostate. Patients with suspicious digital rectal examination, prostate specific antigen above 4 ng/mL, and prostate specific antigen below 4 ng/mL but with suspicious digital rectal examination were included in the study. All biopsies were carried out by a single physician. Results were analyzed by stratifying prostate specific antigen range in the following manner: under 4 ng/mL, from 4.1 to 10 ng/mL, from 10.1 to 20 ng/mL, from 20.1 to 50 ng/mL, and above 50 ng/mL. Likewise, prostatic volume was stratified as ‹50 cc and › 50 cc. Basic statistical tests were carried out using measures of central tendency and dispersion.
Results: One hundred forty-five ultrasound-guided transrectal prostate biopsies were carried out resulting in fortysix prostate cancer diagnoses, six high grade intraepithelial neoplasia diagnoses, and ninety-three benign disease diagnoses. There was 31% overall cancer detection.
Overall cancer diagnosis percentage in the lateral sextant biopsy group, exclusively, was 17.3% and it was 13% in the standard sextant biopsy group. A total of 71.7% of patients in the two sets were cancer positive.
Conclusions: The present study showed an overall 17% increase in cancer detection with lateral biopsy. There was also a 13% exclusive increase with standard or traditional biopsy but these results were not statistically significant.
It was concluded in the present study that both lateral and standard prostate biopsy are indispensable for cancer diagnosis in patients with prostate specific antigen from 4.1 to 10 ng/mL.

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