[The incidence of lesions associated with prostatic biopsy and its effect on the serum concentration of the prostate-specific antigen].
OBJECTIVE
To analyze the incidence of pathoanatomical lesions seen in systematic prostate biopsies and to evaluate their influence on PSA serum levels.


METHODS
495 consecutive prostate biopsies, indicated by a suspicion digital rectal examination in 194 patients (39.2%) and raised serum PSA in 301 (60.8%), were evaluated. Biopsy was performed by sextant and hypoechoic nodes, and PSA serum measurements by dual monoclonal antibody radioimmunoassay, Tandem PSA.


RESULTS
Cancer was diagnosed in 42.6% biopsies and BPH in 67.4%; additionally, other associated lesions were detected in 74.6% cases, the most frequent ones being chronic prostatitis (47.3%), glandular atrophy (35.9%) and acute prostatitis (23%). All lesions were significantly related to the primary BPH diagnosis in 74.2% to 85% cases. High grade PIN (14.1%) was related to primary cancer diagnosis in 87.1% cases. The multivariate analysis showed that the main diagnosis (BPH vs cancer) was the only variable that had a significant influence on PSA serum levels. When BPH patients were considered separately, the only variable with significant influence on PSA serum levels was the prostatic volume. The univariate analysis showed a nonsignificant increase in association with acute prostatitis and high grade PIN, and a decrease in association with chronic prostatitis.


CONCLUSIONS
BPH or cancer associated damage is very frequent in prostatic biopsies. However, the only factors showing a significant contribution to PSA serum levels appear to be the presence or absence of cancer, or the prostatic volume when the main diagnosis is BPH.
Morote Robles
J
J
Servicio de Urología, Hospital Valle Hebrón, Universidad Autónoma, Barcelona.
López López
M
M
Encabo Duro
G
G
de Torres Ramírez
I
I
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001707:Biopsy, Needle / Q000295:instrumentation / Q000379:methods / Q000706:statistics & numerical data; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D011467:Prostate / Q000000981:diagnostic imaging / Q000473:pathology*; D017430:Prostate-Specific Antigen / Q000097:blood*; D011470:Prostatic Hyperplasia / Q000097:blood / Q000000981:diagnostic imaging / Q000453:epidemiology* / Q000473:pathology; D011471:Prostatic Neoplasms / Q000097:blood / Q000000981:diagnostic imaging / Q000453:epidemiology* / Q000473:pathology; D012007:Rectum; D018084:Ultrasonography, Interventional
D017430:Prostate-Specific Antigen
Incidencia de lesiones asociadas en la biopsia prostática y su influencia en la concentración sérica del antígeno prostático específico.