Abstract:
Introduction. Currently, the appropriate number of fragments obtained during a prostate biopsy
in order to detect early histological changes in the prostate tissue is constantly debated.
Aim of the study. To reveal the correlation between the PSA value and the number of biopsies
required to be performed for the detection of prostate cancer.
Materials and methods. The study was conducted on the basis of 52 ultrasonography-guided
prostate biopsies performed between May 2016 - March 2017. The case-control, retrospective
study involved evaluating the results of the 52 biopsies, of which 13: 6-core and 39: 12-core. The
Transrectal Ultrasound-guided Prostate Biopsy (TRUS) was performed according to the National
Clinic Protocol with the main indication being the level of PSA higher than 4 ng/ml and taking
into consideration the contraindications and possible complications that may occur. For
statistical data processing SPSS program was used, applying descriptive and comparative
statistical analysis.
Results. Patients that underwent the biopsy aged between 52 and 88 years, and PSA varied
between 2.81 and 177.00 ng/ml with an average of 89.90 ng/ml. In 22 patients (42.30%) of the
group of subjects who underwent the biopsy, the morphological clinical picture of
adenocarcinoma was found, and in 30 patients (57.69%) – benign prostatic hyperplasia. In none
of the patients any major complications have occured. In patients with 6-core biopsy were detected 8 Benign Prostatic Hyperplasia (BPH) with the average PSA value – 34.98 ng/ml, the
minimum being 7.74 ng/ml and maximum – 10.0ng/ml. Those with 6-core biopsy and
adenocarcinoma (5) had an average PSA of 69.04 ng/ml, the minimum being 14.0 ng/ml and
maximum – 177.0 ng/ml. In patients with 12-core biopsy were detected 22 BPH with the average
PSA value of 14.19 ng/ml, the minimum being 2.81 ng/ml and maximum – 44.0 ng/ml. Those
with 12-core biopsy and adenocarcinoma (17) had an average PSA of 46.0 ng/ml, the minimum
being 9.59 ng/ml and maximum – 140.0ng/ml. Thus, there is a direct interrelation between the
increase of PSA levels in serum and the detection of adenocarcinoma. Even though, this marker
is not totally effective in detecting the PC, which implies the need to use ultrasound-guided
biopsy, it has a direct influence on electing the number of the samples essential for the detection
of the PC.
Conclusions. Although the main method of diagnosis is considered to be 12-core biopsy, it loses
its purpose in cases with PSA higher than 44 ng/ml when the 6-core biopsy has the same
revelatory properties and is less invasive.
