Are prostate biopsies mandatory in patients with prostate‐specific antigen increase during intravesical immuno‐ or chemotherapy for superficial bladder cancer?

The Prostate ◽  
2008 ◽  
Vol 68 (11) ◽  
pp. 1241-1247 ◽  
Author(s):  
Paolo Beltrami ◽  
Lorenzo Ruggera ◽  
Lucia Cazzoletti ◽  
Dionisio Schiavone ◽  
Filiberto Zattoni
Keyword(s):  
Bladder Cancer ◽  
Prostate Specific Antigen ◽  
Superficial Bladder Cancer ◽  
Specific Antigen ◽  
Prostate Biopsies

scholarly journals Personalized Prostate Specific Antigen Testing Using Genetic Variants May Reduce Unnecessary Prostate Biopsies

2013 ◽  
Vol 189 (5) ◽  
pp. 1697-1701 ◽  
Author(s):  
Brian T. Helfand ◽  
Stacy Loeb ◽  
Qiaoyan Hu ◽  
Phillip R. Cooper ◽  
Kimberly A. Roehl ◽  
...  
Keyword(s):  
Prostate Specific Antigen ◽  
Genetic Variants ◽  
Specific Antigen ◽  
Prostate Biopsies ◽  
Prostate Specific Antigen Testing ◽  
Antigen Testing

scholarly journals Persistent Intraprostatic Androgen Concentrations after Medical Castration in Healthy Men

2006 ◽  
Vol 91 (10) ◽  
pp. 3850-3856 ◽  
Author(s):  
Stephanie T. Page ◽  
Daniel W. Lin ◽  
Elahe A. Mostaghel ◽  
David L. Hess ◽  
Lawrence D. True ◽  
...  
Keyword(s):  
Prostate Specific Antigen ◽  
Specific Antigen ◽  
Transrectal Ultrasound ◽  
Receptor Expression ◽  
Prostate Cell ◽  
Hormone Levels ◽  
Prostate Biopsies ◽  
Clinical Consequences ◽  
Normal Men ◽  
The Impact

Abstract Context: The impact of serum androgen manipulation on prostate tissue hormone levels in normal men is unknown. Studies of men with prostate cancer have suggested that prostatic androgens are preserved in the setting of castration. Tissue androgens might stimulate prostate growth, producing adverse clinical consequences. Objective: The objective of the study was to determine the effect of serum androgen manipulation on intraprostatic androgens in normal men. Design: Thirteen male volunteers ages 35–55 yr (prostate-specific antigen < 2.0 ng/ml; normal transrectal ultrasound) were randomly assigned to: 1) a long-acting GnRH-antagonist, acyline, every 2 wk; 2) acyline plus testosterone (T) gel (10 mg/d); or 3) placebo for 28 d. Serum hormones were assessed weekly. Prostate biopsies were obtained on d 28. Extracted androgens were measured by RIA, and immunohistochemistry for androgen-regulated proteins was performed. Results: The mean decrease in serum T was 94%, whereas prostatic T and dihydrotestosterone levels were 70 and 80% lower, respectively, in subjects receiving acyline alone compared with controls (P < 0.05). Despite this decrease in prostate androgens, there were no detectable differences in prostate epithelial proliferation, apoptosis, prostate-specific antigen, and androgen receptor expression. Conclusion: In this small study of healthy subjects, despite a 94% decrease in serum T with medical castration, intraprostatic T and dihydrotestosterone levels remained 20–30% of control values, and prostate cell proliferation, apoptosis, and androgen-regulated protein expression were unaffected. Our data highlight the importance of assessing tissue hormone levels. The source of persistent prostate androgens associated with medical castration and their potential role in supporting prostate metabolism deserves further study.

On the Clinical Usefulness of the Free-to-Total Prostate-Specific Antigen Ratio

2006 ◽  
Vol 21 (1) ◽  
pp. 1-5 ◽  
Author(s):  
S. Ciatto ◽  
T. Rubeca ◽  
R. Franceschini ◽  
C. Trevisiol ◽  
M. Confortini ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Prostate Specific Antigen ◽  
Specific Antigen ◽  
Clinical Usefulness ◽  
Clinical Use ◽  
Prostate Biopsies ◽  
Total Prostate Specific Antigen ◽  
Total Psa

The free-to-total prostate-specific antigen ratio (F/T PSA) is associated with the presence of prostate cancer and is thus used as an indicator for suspicion of prostate cancer and as a determinant for biopsy. We reviewed a recent retrospective series of 966 consecutive prostate biopsies where F/T PSA was blindly determined and did not influence biopsy indication. We simulated the association of F/T PSA with biopsy outcome and its impact as a biopsy determinant. When adopting an F/T PSA cutoff of 10%, 13%, 16% or 20% among random sextant biopsies in the 4–10 ng/mL total PSA range, the sensitivity was 15%, 37%, 55% and 72% and the specificity 89%, 80%, 64% and 44%, respectively. Using F/T PSA as a biopsy determinant, from 1.7 to 2.6 cancer biopsies would have been delayed to avoid 10 benign biopsies. As this balance is not acceptable, F/T PSA has no role as a biopsy indicator and its clinical use is questionable.

Prostate-Specific Antigen Increase during Dutasteride to Indicate the Need for Prostate Biopsy: Influence of Prostatic Inflammation

2017 ◽  
Vol 84 (3) ◽  
pp. 158-164 ◽  
Author(s):  
Alessandro Sciarra ◽  
Martina Maggi ◽  
Andrea Fasulo ◽  
Stefano Salciccia ◽  
Vincenzo Gentile ◽  
...  
Keyword(s):  
Prostate Specific Antigen ◽  
Prostate Biopsy ◽  
Specific Antigen ◽  
Serum Levels ◽  
Prostate Biopsies ◽  
Total Prostate Specific Antigen ◽  
Group A ◽  
Inflammatory Infiltrates ◽  
Prostatic Inflammation

Introduction The aim of this study was to analyze the significance of an increase in total prostate-specific antigen (PSA) serum levels despite dutasteride treatment as a predictor of prostate cancer (PC) at biopsy. We focused our attention on the rate of the first PSA increase and on the influence of prostatic inflammation. Methods From 2011 to 2016, 365 men with a previous negative prostate biopsy and persistent elevated PSA levels received dutasteride treatment. The population was followed for a range of 12-48 months. Results One hundred twelve cases with a confirmed PSA increase >0.5 ng/ml over the nadir value during the follow-up were included in Group A and underwent a new prostate biopsy. In Group A, the PSA increase was associated with PC at the re-biopsy in 66% of cases. The percentage of PSA reduction after 6 months of treatment was not a significant indicator of the risk for PC. The distribution of inflammatory infiltrates significantly (p<00.01) varied from positive to negative prostate biopsies. The relative risk for PC at biopsy significantly increased according to PSA level during dutasteride. Conclusions Treatment with dutasteride can help to analyze PSA kinetic. A persistent prostatic inflammation is a factor able to reduce the performance of PSA kinetic during dutasteride treatment.

Serum proPSA as a marker for reducing repeated prostate biopsy numbers

2017 ◽  
Vol 42 (1) ◽  
Author(s):  
Sema Nur Ayyıldız ◽  
Tevfik Noyan ◽  
Ali Ayyıldız ◽  
Erdal Benli ◽  
Abdullah Çırakoğlu ◽  
...  
Keyword(s):  
Prostate Specific Antigen ◽  
Prostate Biopsy ◽  
Prostate Volume ◽  
Specific Antigen ◽  
Lower Sensitivity ◽  
Health Index ◽  
Prostate Biopsies ◽  
Prostate Health Index ◽  
Total Psa ◽  
Prostate Health

AbstractIntroduction:Prostate specific antigen (PSA) has a lower sensitivity and specifity range of 4–10 ng/mL. We aimed to investigate the effectiveness of pPSA in reducing number of prostate biopsies.Methods:This study enrolled 80 patients aged 50 years or older whom had serum total PSA levels between 4 ng/dL and 10 ng/dL. Age, prostate volume, tPSA, fPSA, pPSA, PSA%, pPSA%, t/pPSA, f/pPSA, p/fPSA, p/tPSA, f/p/tPSA, p/f/tPSA, PSAD, fPSA/PSAD, pPSA/PSAD, (Prostate Health Index) PHI, (t/f/pPSA)/tPSA, and PHI2 (New Prostate Health Index) biopsy results were compared between subjects BPH and PCa.Results:Out of 80 subjects, 23 (29%) had PCa and 57 (71%) had BPH. Prostate volume was 51.65 mL in PCa and 64.85 mL in non-PCa group (p>0.05). The rate of PCa increased as prostate volume was reduced and age increased. fPSA, PSA%, p/f/tPSA, fPSA/PSAD values were significant in favor of respectively; BPH, BPH, PCa and BPH (p<0.05).Discussion:Using prostate health index (PHI) was beneficial for predicting PCa. In addition, using pPSA in formulas such as (PHI2) pPSA/(fPSA*√tPSA), p/f/tPSA, (t/f/pPSA)/tPSA may also be useful. This study suggests that the use of pPSA may have a role in reducing the number of prostate biopsies in differentiating PCa and BPH.

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