Predicting the extent of prostate cancer using a combination of serum prostate-specific antigen-alpha(1)-antichymotrypsin complex and systematic biopsy.
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.
Miyake
Hideaki
H
Department of Urology, Kobe University School of Medicine, Kobe, Japan.
Hara
Shoji
S
Yamanaka
Nozomu
N
Ono
Yoshiharu
Y
Eto
Hiroshi
H
Yamada
Yuji
Y
Takechi
Yoshizumi
Y
Arakawa
Soichi
S
Kamidono
Sadao
S
Hara
Isao
I
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*
D046911:Macromolecular Substances; D000514:alpha 1-Antichymotrypsin; D017430:Prostate-Specific Antigen