PSA’sı 20 ng/ml ve üzerindeki vakalarda yapılan transrektal ultrasonografi eşiliğindeki prostat biyopsilerinde prostat kanseri saptama oranı ve optimal biyopsi şemasının belirlenmesi

Abstract

Prostate cancer is an important health problem among men at later ages and it is the most common solid tumor in Europe. It is the second most common reason for mortality from cancer. Diagnosis of prostate cancer is carried out by confirmation of tissue diagnosis of clinic suspicion in which serum PSA value and rectal digital examination are used together. Patients whose prostate biopsy was done between January 2007 and December 2014 and whose PSA value was 20 ng/ml and above were divided into three groups as 1. group:20-49,99 ng/ml, 2. group:50-99,99 ng/ml, 3.group:100 ng/ml and above. Among these three groups; as PSA value increased; the rate of determination of prostate cancer, gleason score; existence of perineural invasion was determined statistically significant. The rate of determination of prostate cancer among patients whose prostate volume below 50 cc in 1. Group and 2. Group was higher compared to those whose prostate volume was 50 cc and above. In these two groups, as the volume of prostate increases, the rate of getting cancer decreases. In rectal examination, 51.2% BPH was determined in the 1. Group patients who do not have nodule. In the existence of nodule, when groups were compared, as PSA value increased, the increase in rate of determination of prostate cancer was statistically significant. In our study, we compared sensitivity values according to scenarios which was composed by taking less core biopsy instead of 12 core biopsy. As a result of the study; in the event that there are at least 2 core biopsy in group whose PSA value is 100 ng/ml and above, at least 4 biopsy in the group whose PSA value was 50-99,99 ng/ml; at least 6 biopsy in the group whose PSA value was 20-49,99 ng/ml, it was observed that prostate cancer diagnosis can be made at above 95% sensitivity when compared with 12 core biopsy. As a result; literature data of today is generally focused on patients whose PSA value is below 20. In this study, it was presented together with percentage values that different rates of BPH and prostate cancer was determined on patients whose PSA value is above 20 ng/L. We believe that these data can be beneficial in the stages of giving information to the patients and taking consent of patients. Moreover, the aim in prostate biopsy is making diagnosis of prostate cancer through giving the least discomfort to patient and making the least morbidity. In this study, it was presented that diagnosis can be made with higher sensitivity with biopsy taken from less number of focuses instead of 12 core biopsy among patients whose PSA value is 20 ng/ml