Predicting the extent of prostate cancer using a combination of serum prostate-specific antigen-alpha(1)-antichymotrypsin complex and systematic biopsy

• Published in: Urologia internationalis Vol. 68; no. 4; p. 232
• Main Authors: Miyake, Hideaki, Hara, Shoji, Yamanaka, Nozomu, Ono, Yoshiharu, Eto, Hiroshi, Yamada, Yuji, Takechi, Yoshizumi, Arakawa, Soichi, Kamidono, Sadao, Hara, Isao
• Format: Journal Article
• Language: English
• Published: Switzerland 2002
• Subjects: Aged; alpha 1-Antichymotrypsin - blood; Biopsy; Humans; Macromolecular Substances; Male; Predictive Value of Tests; Prostate-Specific Antigen - blood; Prostatic Neoplasms - blood; Prostatic Neoplasms - pathology; Retrospective Studies
• ISSN: 0042-1138
• DOI: 10.1159/000058441

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.
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.
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).
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.