Current status of prostate biopsy in Chinese Prostate Cancer Consortium member hospitals

Abstract

Objective This multi-center study aims to investigate the PSA level, prostate volume, biopsy scheme and biopsy method of patients receiving prostate biopsy in Chinese Prostate Cancer Consortium (CPCC) hospitals and identify the detection rate of prostate cancer (PCa) in different PSA ranges in Chinese. Methods Detailed clinical information of consecutive patients underwent prostate biopsy in 33 CPCC hospitals were recorded with EpiData Entry 3.1. Those information included PSA level, prostate volume, biopsy scheme and biopsy method. All statistics analysis was performed with SPSS 17.0. T test was applied to compare age between different groups. Mann-Whitney U test was applied to compare PSA, prostate volume, and percent free PSA. Results A total of 19292 cases were collected. After excluding cases with factors that would influence PSA level, 13904 cases from 22 hospitals were involved in further investigation. The medium volume of prostate was 44.0ml (range 31.1~65.5 ml). The distribution of patients in different PSA level included 701 cases (5%) in PSA 50.0 μg/L. There were 10808 cases who underwent transrectal ultrasound-guided prostate biopsy and 3087 cases who underwent transperineal biopsy. There were 312(2%), 1436(10%), 2640(19%), 3920(28%), 4989(36%) and 607(4%) cases who underwent non-systematic biopsy, 6-, 8-, 10-, 12- core and saturation biopsy, respectively. PCa detection rates were 44%, 26% and 35% in all patients, patients with PSA 4.1-10.0 μg/L and 10.1-20.0 μg/L, respectively. The distribution of Gleason scores in those patients with positive biopsy included the 1295 cases (21%) with less than 7 scores, 1164 cases (19%) with 3+ 4 scores, 1155 cases (19%) with 4+ 3 scores, 2371 cases with more than 8 scores and 138 cases (2%) with uncertain scores. Conclusion The most widely applied biopsy scheme in CPCC hospitals is transrectal ultrasound-guided biopsy. The PSA level of patients in CPCC hospitals is relatively high. The relationship between PSA level and PCa detection rate in Chinese population is different from reports in Western population. Key words: Prostatic neoplasms; Early diagnosis; Prostate-specific antigen; Prostate biopsy