1. PSA repeatedly fluctuating levels are reassuring enough to avoid biopsy?
- Author
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Taverna G, Grizzi F, Minuti F, Seveso M, Piccinelli A, Giusti G, Benetti A, Maugeri O, Pasini L, Zandegiacomo S, Colombo P, Di Biccari S, and Graziotti P
- Subjects
- Adult, Aged, Aged, 80 and over, Humans, Male, Middle Aged, Predictive Value of Tests, Prostatic Neoplasms immunology, Prostatic Neoplasms pathology, Reproducibility of Results, Biomarkers, Tumor blood, Biopsy, Prostate-Specific Antigen blood, Prostatic Neoplasms diagnosis
- Abstract
Introduction: Prostate-specific antigen (PSA) levels can show wide fluctuations when repeatedly measured. Here we investigatewd if: (a) biopsy timing influences the prostate cancer (PC) detection rate in patients with fluctuating PSA (flu-PSA) in comparison with patients with steadily increasing PSA (si-PSA); (b) PSA slope estimated in patients with flu-PSA predicts a different risk of cancer detection; (c) flu-PSA and si-PSA patients develop PC in topographically different sites; (d) the behaviour of pre-operative PSA is an expression of a disease with defferent characteristics to the following radical prostatectomy., Methods: The study involved 211 patients who underwent at least a second biopsy after a first negative prostate biopsy. PSA Slope, PSA velocity (PSAV) and PSA doubling time (PSADT) were estimated. Flu-PSA level was defined as a PSA series with at least one PSA value lower than the one immediately preceding it., Results: 82 patients had flu-PSA levels and 129 si-PSA levels. There were no significant differences between the two groups in terms of cancer detection, clinical or pathological stage, but the si-PSA group with cancer had a higher Gleason score. No difference was found for PSA Slope between flu-PSA patients with cancer and those without., Conclusions: Our study demonstrates no difference in PC detection rate at repeat biopsy between patients with flu or si-PSA levels. PSA Slope, PSAV and PSADT were not found helpful tools in cancer detection.
- Published
- 2009