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Park, Hong, Byun, and Lee: Comparison of the Rate of Detecting Prostate Cancer and the Pathologic Characteristics of the Patients with a Serum PSA Level in the Range of 3.0 to 4·0πがml and the Patients with a Serum PSA Level in the Range 4.1 to 10.0nダml
Original Article

Korean J Urol 2006;47(4):358-361.

Published online: 18 December 2006

DOI: https://doi.org/10.4111/kju.2006.47.4.358

Comparison of the Rate of Detecting Prostate Cancer and the Pathologic Characteristics of the Patients with a Serum PSA Level in the Range of 3.0 to 4·0πがml and the Patients with a Serum PSA Level in the Range 4.1 to 10.0nダml

Hyoung Keun Park, Sung Kyu Hong1, Seok-Soo Byun, Sang Eun Lee1,

1From the Departments of Urology College of Medicine, Dongguk University, Gyeongju

2Seoul National University, Seoul, Korea

Corresponding Author: Lee Sang-eun Department of Urology, Seoul National University Bundang Hospital Gumi-dong, Bundang-gu, Seongnam-si, Gyeonggi-do 300 street ? 705-034 TEL: 031-787-7349 FAX: 031-787-4057 E-mail: selee@snubh.org

Received 7 October 2005       Accepted 3 December 2005

Copyright © 2006 The Korean Urological Association

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Purpose:

We prospectively evaluated the prostate cancer detection rate and pathologic characteristics of patients with a serum prostate-specific antigen (PSA) level of 3.0 to 4.0ng/ ml and we compared this with the patients who had a PSA level in the range of 4.1 to 10.0ng/ ml.

Materials and Methods:

We analyzed the data of patients who had PSA levels of 3.0 to 10.0ng/ml, benign findings on digital rectal examination (DRE) and no specific lesion identified on transrectal ultrasound. The clinical characteristics, cancer detection rate and pathologic findings of the biopsy and prostatectomy specimen were compared between the low (3.0 to 4.0ng/ml) and intermediate (4.1 to 10.0ng/ml) PSA groups.

Results:

A total of 370 patients met our criteria and so they were included in the study. Sixty five and 305 patients had low or intermediate PSA levels, respectively. The mean age and the number of prostate biopsy cores were not different between the two groups. Prostate cancer was diagnosed in 26% of the low PSA group and in 20% of the intermediate PSA group. No significant difference was found between the two groups on the pathologic findings of the biopsy and on the pathology findings of the prostatectomy specimens, including the mean Gleason score, the percentage of patients with a Gleason score 7 or higher, the pathologic stage and the percentage of insignificant prostate cancer.

Conclusions:

No statistically significant difference was found in the incidence of prostate cancer or pathological characteristics on comparison between the low and intermediate PSA groups. These results suggest that a lower PSA cutoff should be considered as an indication for a prostate biopsy in the Korean population. (Korean J Urol 200b;47:358-361)

Keywords: Prostate-specific antigen, Prostate cancer, Biopsy

REFERENCES

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Table 1.
Characteristics of patients undergoing biopsy as stratified by the PSA level
  3.0-4.0ng/ml 4.1-10.0ng/ml p-value
No. of patients 65 305  
Mean age (years) 62.4±6.9 62.8±9.3 0.76
Prostate volume (ml) 40.6±12.6 48.9±21.3 0.01
PSA density (ng/ml/ml) 0.096±0.02 0.152±0.07 <0.001
Cores per biopsy 13.1±1.3 13.4±1.9 0.14

PSA: prostate-specific antigen

Table 2.
Pathologic characteristics of the biopsy specimens with prostate cancer as stratified by the PSA level
  3.0-4.0 ng/ml 4.1-10.0 ng/ml p-value
No. of patients with prostate cancer (%) 17 (26.2%) 62 (20.3%) 0.57
Mean age (years) 65.9±4.5 66.0±5.5 0.80
Mean Gleason score 6.2±0.8 6.5±0.7 0.23
No. of patients with Gleason score 7 or higher (%) 5 (29.4) 24 (38.7) 0.48
Percentage of positive core (%) 26.6 21.4 0.36

PSA: prostate-specific antigen

Table 3.
Pathologic characteristics of the prostatectomy specimens with prostate cancer as stratified by the PSA level
  3.0-4.0ng/ml 4.1-10.0ng/ml p-value
No. of patients underwent prostatectomy 13 25  
Mean Gleason score 6.5±0.5 6.6±0.5 0.84
Percentage of tumor in specimen (%) 11.0±10 14.1±13 0.54
Percentage of organ-confined tumor (%) 92.3 91.4 0.92
Surgical margin positive rate (%) 31.0 40.0 0.57
Percentage of insignificant cancer (%) 23.1 17.1 0.64

PSA: prostate-specific antigen, insignificant cancer: Gleason score 6 or less and tumor volume < 0.5cm3

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