[Our experience about utility of the prostate mapping (8 + 8 biopsy) in the diagnosis of prostate tumour].
OBJECTIVE
Can patients derive a real benefit from increasing the number of prostate biopsies as regards Hodge's method (3 biopsies PZ per lobe) or can they only suffer from an eventual increase in complications?


METHODS
From January 1998 to May 2001 we did 324 biopsies sextant with 6 biopsies (3 biopsies PZ per lobe), 146 of which (45%) were positive for tumour. We did the prostate mapping (6 PZ: 1 TZ: 1 AZ per lobe) on 97 patients who kept on having PSA alterations even though they were negative. Of these 97, 10 (10.3%) had a PSA between 3 and 4 ng/ml and pathological rate PSA free/total, 35 (36.1%) had a PSA greater than 10 ng/ml and 52 (53.6%) had a PSA between 4 and 1.0 ng/ml with a pathological rate PSA free/PSA total. Dividing the patients according to the prostate volume, 67 (69%) had a prostate less than 50 ml and 30 (31%) had a prostate volume superior to 50 ml.


RESULTS
Of the 97 patients tested 27 (27.8%) were positive for tumour with an increase in diagnosis of 18.49%. 3 patients out of 10 (30%) with a PSA less than 4 ng/ml were positive for tumour with an increase in diagnosis of 12.5%. 15 patients out of 52 (28.8%) with a PSA between 4 and 10 ng/ml and rate pathological PSA free/PSA total were positive for tumour with an increase in diagnosis of 30% and 9 out of 35 (25.5%) with PSA superior to 10 ng/ml were positive with an increase in diagnosis of 12%. Stratifying the data about prostate volume, 10 patients out of 67 (14.62%) with a prostate volume less than 50 ml were positive, with an increase in diagnosis of 10.5% and 8 patients out of 30 (26.6%) with a prostate volume greater than 50 ml were positive with an increase in diagnosis of 15.68%.


CONCLUSIONS
In our experience, prostate mapping increased of 18.49% the rate of positive diagnoses compared with the classic protocol proposed by Hodge. It resulted useful, in particular for the patients with PSA between 4 and 10 ng/ml (increase in diagnosis of 30%) and for the patients with prostate volume greater than 50 ml (increase in diagnosis of 15.68%). Obviously, according to our results, we propose the prostate mapping to patients with persisting high PSA after negative biopsies and after having excluded contagious-inflammation pathologies.
Parravicini
Michele
M
Divisione di Urologia, Azienda Ospedaliera della Provincia di Lodi, Lodi, Italy. mparravi@tiscalinet.it
Del Boca
Carlo
C
D000368:Aged; D001706:Biopsy; D006801:Humans; D008297:Male; D008875:Middle Aged; D011467:Prostate / Q000473:pathology*; D017430:Prostate-Specific Antigen; D011471:Prostatic Neoplasms / Q000175:diagnosis* / Q000473:pathology*
D017430:Prostate-Specific Antigen