title: Cancer diagnosis with prostate specific antigen greater than 10 ng./ml. and negative peripheral zone prostate biopsy.
abstract: OBJECTIVE
  We assessed the results of additional diagnostic procedures in men with prostate specific antigen (PSA) more than 10 ng./ml. and a peripheral zone prostate biopsy negative for cancer.
  
  
  METHODS
  A total of 68 men with PSA more than 10 ng./ml. and a peripheral zone biopsy negative for cancer was investigated with 1 or more peripheral zone biopsies (17), prostatectomy (18), or 1 or more peripheral zone biopsies and needle biopsy of the transition zone or prostatectomy (33).
  
  
  RESULTS
  Cancer was detected in 20 of 68 patients (29%) with 1 or more additional diagnostic procedures. Of 51 patients whose transition zone was biopsied or who underwent prostatectomy 16 had cancer, and in 8 the malignancy appeared to be isolated to the transition zone. Mean PSA density and proportion of patients with PSA density more than 0.15 were significantly greater and mean prostate volume was significantly less in the 20 patients with compared to 31 without identifiable cancer.
  
  
  CONCLUSIONS
  At least 30% of men with PSA more than 10 ng./ml. and a negative peripheral zone biopsy have prostate cancer. In approximately 50% of cases the cancer appears to reside in the transition zone, and transition zone biopsy or prostatectomy is required for diagnosis.
authors.affiliation: Division of Urology, University of Mississippi Medical Center, Jackson, USA.
authors.forename: J E
authors.initials: JE
authors.lastname: Fowler
authors.forename: M A
authors.initials: MA
authors.lastname: Condon
authors.forename: F L
authors.initials: FL
authors.lastname: Terrell
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001706:Biopsy; D006801:Humans; D008297:Male; D008875:Middle Aged; D017430:Prostate-Specific Antigen / Q000097:blood*; D011471:Prostatic Neoplasms / Q000097:blood* / Q000175:diagnosis*
chemical_list: D017430:Prostate-Specific Antigen