[Is it convenient in a screening programme for prostate tumour to do biopsy in people with PSA between 3 and 3.9 ng/ml?].

PURPOSE OF THE WORK

Is it convenient to do the prostate biopsy for the patients with PSA between 3 and 3.9 ng/ml?

MATERIALS AND METHODS

From January 1998 to April 2001 we did 421 transrectal prostate biopsies echoconducted, 84 of which (20%) done on patients with a PSA between 3 and 3.9 ng/ml. 84.34 (40%) of them had a rectal exploration or a transrectal prostate echography suspected, apart from the value of PSA free/PSA total relation and 50 (60%) had a PSA free/PSA total relation below 0.15, even though they did not have a rectal exploration or a suspect TR transrectal prostate echography.

RESULTS

Of the 84 patients, with PSA between 3 and 3.9 ng/ml, who had undergone a prostate biopsy, 15 (16.6%) were positive for prostate adenocarcinoma. Of 34 patients who, besides having a PSA between 3 and 3.9 ng/ml, had a rectal exploration or a suspect transrectal prostate echography, 7 (20.5%) were positive for prostate tumour, 4 of which (57.14%) had a Gleason score greater than 7 and 3 (12.86%) a Gleason less than 7. Of the 50 patients who had a PSA free/PSA total relation less than 0.15 and did not have a rectal exploration or a suspect transrectal prostate echography, 8 (16%) were positive for prostate adenocarcinoma, 7 of which (87.5%) had a Gleason score greater than 7 and 1 (12.5%) a Gleason score less than 7. Observing that, during the period considered, we obtained 173 overall diagnoses of prostate tumour, we can note that 15 diagnoses (8.66%) had in the whole a PSA between 3 and 3.9 ng/ml, 7 of which (4.04%) had a rectal exploration and a suspect TR prostate echography and 8 (4.62%) had a PSA free/PSA total relation inferior to 0.15. During the period considered, the overall diagnoses of prostate tumour with Gleason greater than 7 were 60 (35%); according to the data of this research, 10 (16%) had a PSA between 3 and 3.9%. Of these 10.7 patients (11%) had a pathological PSA free/PSA total relation and 3 patients (5%) had a pathological rectal exploration or a suspect echography. Instead, the overall diagnosis of prostate tumour with Gleason less than 7 were 113 (65%), 5 (4.4%) had a PSA between 3 and 3.9 ng/ml, 4 of which (3.5%) had a suspect rectal exploration and 1 (0.8%) had a pathological PSA free/PSA total relation.

CONCLUSIONS

Doing biopsy on patients with PSA between 3 and 3.9 ng/ml and with rectal exploration and suspect TR prostate echography does not permit a remarkable increase in diagnosis of prostate tumour (4.4%). Doing prostate biopsy on patients with PSA between 3 and 3.9 ng/ml and pathological PSA free/PSA total relation, allows a more considerable increase in diagnosis of prostate tumour with Gleason score greater than 7 even if it does not permit a remarkable increase in positive diagnosis (4.62%).