title: [Results of a series of transrectal ultrasound guided biopsy of the prostate in 6000 patients. Part II: PSA derived parameters].
abstract: OBJECTIVE
  We review the results of 6000 patients with the clinical suspect of prostate cancer who underwent one or more prostate, biopsies, analyzing the role of PSA derived parameters in the probability of having prostate cancer in the TRUS biopsy.
  
  
  METHODS
  We selected 6000 patients who under- went TRUS biopsy between 1994 and 2002. 861 of them underwent more than one is biopsy, adding up to a total of 7127 biopsies. For the study of PSA derived indexes we established ranges based on the 10th percentile for the first biopsy for all patients and also for those with PSA between 4 and 10 ng/ml. Several predictive models were determined by logistic regression of the variables related with presence/no presence of cancer.
  
  
  RESULTS
  For first biopsies the ranges of PSAD established showed a diagnostic effectiveness below 8% with PSA densities lower than 0.11 ng/ml/cc. The free/total PSA ratio is less discriminant in the ranges obtained with a 13.7% incidence of prostate cancer for values above 0.24. In the case of second biopsies the group of patients with PSAD below 0.12 had only a 5.3% incidence, and only one patient with F/T PSA ratio higher than 0.24 had a prostate cancer (2.9%). All studied parameters but F/T PSA ratio showed statistical significance in the multivariant analysis.
  
  
  CONCLUSIONS
  Although the establishment of a cut point for PSAD diminishes sensitivity, prostate biopsy habits should be modified assuming the loss of tumors in patients with low PSAD and increasing the number of biopsies in patients with total PSA values below 4 ng/ml with higher densities.
authors.affiliation: Unidad de Ecografía Urológica, Universidad de Alcalá de Henares, Madrid. España. rafael.rodriguezpatron@wanadoo.es
authors.forename: Rafael
authors.initials: R
authors.lastname: Rodríguez-Patrón Rodríguez
authors.forename: Teodoro
authors.initials: T
authors.lastname: Mayayo Dehesa
authors.forename: Francisco Javier
authors.initials: FJ
authors.lastname: Burgos Revilla
authors.forename: Mónica
authors.initials: M
authors.lastname: Alonso González
authors.forename: Alberto
authors.initials: A
authors.lastname: Lennie Zucharino
authors.forename: Ricardo
authors.initials: R
authors.lastname: García González
mesh_terms: D001706:Biopsy / Q000379:methods; D006801:Humans; D008297:Male; D017430:Prostate-Specific Antigen / Q000097:blood; D011471:Prostatic Neoplasms / Q000097:blood / Q000175:diagnosis* / Q000000981:diagnostic imaging; D012007:Rectum; D014463:Ultrasonography
chemical_list: D017430:Prostate-Specific Antigen