Prediction of the extent of prostate cancer by the combined use of systematic biopsy and serum level of cathepsin D.
BACKGROUND
The objective of this study was to assess the usefulness of combined systematic prostate biopsy with the serum level of cathepsin D, which has recently been shown to be a useful marker for prostate cancer, to predict the disease extension.


METHODS
Seventy-two patients with clinically organ-confined disease who underwent radical prostatectomy were evaluated for serum prostate-specific antigen (PSA) and cathepsin D levels, systematic biopsy, and pathological stage.


RESULTS
The incidence of extraprostatic disease in patients with more than half the biopsy cores positive or > or = 15 ng/mL cathepsin D was significantly higher than that in patients with less than half the biopsy cores positive or < 15 ng/mL cathepsin D, respectively; whereas cancer in bilateral lobes or > or = 10 ng/mL PSA could not be used as a predictor of extraprostatic disease. Furthermore, in patients with more than half the biopsy cores positive and > or = 15 ng/mL cathepsin D 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 the biopsy cores positive and < 15 ng/mL cathepsin D or those with less than half the biopsy cores positive and < 10 ng/mL PSA, respectively. Furthermore, the prediction of the incidence of extraprostatic disease using these three variables was significantly more accurate than using two of the variables (percentage positive biopsy cores plus serum cathepsin D or PSA).


CONCLUSIONS
Systematic biopsy together with serum cathepsin D and/or PSA was a useful predictor of the extent of prostate cancer. Patients with more than half the biopsy cores positive, > or = 15 ng/mL cathepsin D and/or > or = 10 ng/mL PSA could avoid prostatectomy because there is a significantly high probability that they already have extraprostatic disease.
Miyake
Hideaki
H
Department of Urology, Hyogo Medical Center for Adults, 13-70 Kitaohji-cho, Akashi 673-8558, Japan. hideakimiyake@hotmail.com
Hara
Isao
I
Eto
Hiroshi
H
D000368:Aged; D014408:Biomarkers, Tumor / Q000097:blood; D001707:Biopsy, Needle / Q000379:methods; D002402:Cathepsin D / Q000097:blood*; D006801:Humans; D008297:Male; D009367:Neoplasm Staging; D011237:Predictive Value of Tests; D017430:Prostate-Specific Antigen / Q000097:blood; D011468:Prostatectomy / Q000379:methods; D011471:Prostatic Neoplasms / Q000175:diagnosis*; D012189:Retrospective Studies
D014408:Biomarkers, Tumor; D017430:Prostate-Specific Antigen; D002402:Cathepsin D