Journal List > Korean J Urol > v.47(9) > 1069980

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Choi, Yoo, and Park: The Significance of Prostate-specific Antigen after Transrectal Prostate Biopsy
Original Article
Korean Journal of Urology

Korean Journal of Urology 2006; 47(9): 958-962.

Published online: 30 September 2006

DOI: https://doi.org/10.4111/kju.2006.47.9.958

The Significance of Prostate-specific Antigen after Transrectal Prostate Biopsy

Seock Hwan Choi, Eun Sang Yoo1, Youg II Park

Department of Urology, Fatima Hospital, Daegu, Korea.

1Department of Urology, Kyungpook National University School of Medicine, Daegu, Korea.

Corresponding author (uropone@yahoo.co.kr)

Received 3 March 2006       Accepted 9 August 2006

Copyright © 2006 The Korean Urological Association

Abstract

Purpose

The serum prostate-specific antigen (PSA) level is increased after needle biopsy (Bx) of the prostate. This study tested the hypothesis that the prostate that harbors malignant lesions demonstrates less leakage of PSA after transrectal prostate Bx, and this phenomenon can be helpful in discriminating benign protrates from cancer ous prostrates.

Materials and Methods

Eighty three patients were included in this prospective study because they had an increase PSA level (from 4 to 30ng/ml) and/or an abnormal digital rectal examination, and the serum PSA level was checked 60 minutes later after biopsy. We checked the pre-Bx total serum PSA, the post-Bx total serum PSA and the PSA ratio (post-Bx total serum PSA to pre-Bx total serum PSA), and we analyzed the sensitivity, specificity, positive predictive value, negative predictive value and the statistical differences.

Results

Of the 31 men whose PSA ratio was less than 2.0, 27 (87%) men were proven to have prostate cancer. Of the 52 men whose PSA ratio was greater than 2.0, 49 (94%) were proven to have benign lesions. When setting 2.0 as the cutoff value, the difference was statistically significant (p<0.001); the sensitivity was 90.0%, the specificity 92.4%, the positive predictive value (PPV) 87.0% and the negative predictive value (NPV) 94.2%.

Conclusions

Evaluating the 1-hour PSA ratio might be helpful for clinicians to diagnosis the high risk patients who might have cancer in their prostate glands. Repeat biopsy should be considered for patients who initially had negative biopsy results with a smaller PSA ratio.

Keywords: Prostate cancer, Prostate-specific antigen, Needle biopsy

Figures and Tables

Fig. 1
Receiver operating characteristics (ROC) curve using multiple cutoff values of the prostate-specific antigen (PSA) ratio, including 1.5, 2.0, 2.5, 3.0 and 3.5.
kju-47-958-g001
Table 1
Characteristics of the study groups
kju-47-958-i001

BPH: benign prostatic hyperplasia, PSA: prostate-specific antigen, SD: standard deviation, *: PSA 1 hour after biopsy, †: ratio of PSA change 1 hour after biopsy to baseline PSA

Table 2
Results of using multiple cutoff values of the PSA ratio
kju-47-958-i002

BPH: benign prostatic hyperplasia, PSA: prostate-specific antigen

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