Beneficio de la realización de antígeno prostático específico total en pacientes con próstata grado III

Abstract

IntroductionPSA is a specific biochemical marker for prostate disease, but is unable to differentiate between malignant tumors, benign or inflammatory diseases of the prostate. Prostate volume is an important factor related to the level of PSA, prostate cancer and benign prostate hyperplasia. There are studies of the relationship between PSA levels and prostate size in which a direct relationship between PSA and gland volume has been found. So far there are not sufficient studies that address the need for prostate biopsy in patients with prostate volume greater than 60 grs, and who have elevated PSA.In this paper we show the benefit of measuring total PSA on prostate cancer patients with Grade III prostate. The percentage of patients with positive disease is about 1%. Materials and methodsA retrospective analysis was conducted on a series of patients treated with transvesical prostatectomy, and who underwent transrectal prostate biopsy due to high PSA values and we compared the pathology results of the biopsy with the pathology of the specimen. The success rates and complications of this procedure and the high PSA values, and the pathology of transvesical adenomectomy of the prostate. ResultsTaking a population of 204 patients with elevated PSA, with Prostate Grade III, with a previously negative prostate biopsy was performed by transvesical adenomectomy, showing that 98.6% of the patients (n:201) had negative histopathology for malignancy. This study shows that the incidence of prostate cancer is modified with prostate volume, ranging from 67.2% in volumes <20cc to 19.7% in prostates >60 c.c. ConclusionsThe standard cutoffs of PSA are not suitable for a correct diagnosis of PC. The volume has a significant influence on their levels as well as the usefulness of the test. The cutoff threshold should be reduced in smaller prostates and increased for larger ones. A prostate gland biopsy is not justified in volumes >60cc or grade III with PSA <10ng/ml.© 2011 Sociedad Colombiana de Urología. Published by Elsevier España, S.L. All rights reserved.