title: Predicting the extent of prostate cancer using a combination of serum prostate-specific antigen-alpha(1)-antichymotrypsin complex and systematic biopsy.
abstract: OBJECTIVE
  The objective of the present study was to evaluate the usefulness of the combined systematic biopsy with serum prostate-specific antigen-alpha(1)-antichymotrypsin complex (PSA-ACT) level to predict the extent of prostate cancer.
  
  
  METHODS
  Sixty-two patients with clinically organ-confined disease who underwent radical prostatectomy were evaluated for serum PSA and PSA-ACT levels, systematic biopsy, and the pathological stage.
  
  
  RESULTS
  The incidence of extraprostatic disease in patients with more than half the biopsy cores positive or > or = 8 ng/ml PSA-ACT was significantly higher than those with less than half positive or <8 ng/ml PSA-ACT, respectively, whereas cancer in bilateral lobes or > or = 10 ng/ml PSA could not be used as a predictor of extraprostatic disease. Furthermore, in those with more than half the biopsy cores positive and > or = 8 ng/ml PSA-ACT or those with more than half the biopsy cores positive and > or = 10 ng/ml PSA, extraprostatic disease was significantly more common than in those with less than half positive and <8 ng/ml PSA-ACT or those with less than half positive and <10 ng/ml PSA, respectively. However, the incidence of extraprostatic disease predicted by these three variables was not significantly better than those by the two variables (percentage positive biopsy cores plus serum PSA-ACT or PSA).
  
  
  CONCLUSIONS
  The combined systematic biopsy with serum PSA-ACT or PSA could be used as a useful predictor for the extent of prostate cancer. Patients with more than half the biopsy cores positive and > or = 8 ng/ml PSA-ACT or > or = 10 ng/ml PSA could avoid a prostatectomy because there is a high probability that they have extraprostatic disease.
authors.affiliation: Department of Urology, Kobe University School of Medicine, Kobe, Japan.
authors.forename: Hideaki
authors.initials: H
authors.lastname: Miyake
authors.forename: Shoji
authors.initials: S
authors.lastname: Hara
authors.forename: Nozomu
authors.initials: N
authors.lastname: Yamanaka
authors.forename: Yoshiharu
authors.initials: Y
authors.lastname: Ono
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Eto
authors.forename: Yuji
authors.initials: Y
authors.lastname: Yamada
authors.forename: Yoshizumi
authors.initials: Y
authors.lastname: Takechi
authors.forename: Soichi
authors.initials: S
authors.lastname: Arakawa
authors.forename: Sadao
authors.initials: S
authors.lastname: Kamidono
authors.forename: Isao
authors.initials: I
authors.lastname: Hara
mesh_terms: D000368:Aged; D001706:Biopsy; D006801:Humans; D046911:Macromolecular Substances; D008297:Male; D011237:Predictive Value of Tests; D017430:Prostate-Specific Antigen / Q000097:blood*; D011471:Prostatic Neoplasms / Q000097:blood* / Q000473:pathology*; D012189:Retrospective Studies; D000514:alpha 1-Antichymotrypsin / Q000097:blood*
chemical_list: D046911:Macromolecular Substances; D000514:alpha 1-Antichymotrypsin; D017430:Prostate-Specific Antigen