Kinetics of serum total and free prostate-specific antigen (PSA) after extended multisite prostate biopsy: Comparison among biopsy, transurethral resection of the prostate (TURP), and biopsy plus TURP
Received 16 July 2008; received in revised form 10 October 2008; accepted 10 October 2008. published online 29 December 2008.
Abstract
Background
The kinetics and reproducibility of serum prostate-specific antigen (PSA) following extended multisite biopsies are unknown. The aim of this study was to examine the kinetics of hematogenous leakage of PSA molecules by comparing the postintervention PSA manner among extended biopsies, transurethral resection of the prostate (TURP) and biopsy plus TURP.
Methods
Total and free PSA values were examined before and sequentially after intervention (at 1 hour, 24 hours, 2 days, 14 days, and 28 days), in patients who underwent 14-core prostate biopsy (Biopsy, n = 53), TURP (TURP, n = 21), or prostate biopsy plus TURP (Biopsy+TURP, n = 18).
Results
Ten patients in the Biopsy group were histologically diagnosed as having prostate cancer, and all other patients were diagnosed with non-malignant disorders. One hour after intervention, the increase in total PSA in the Biopsy group (mean 19.58 ± 24.78-fold) and Biopsy+TURP group (mean 14.00 ± 10.52-fold) was higher than that of the TURP group (mean 6.189 ± 7.567-fold) (P = 0.0207 and 0.0119, respectively). The increase in total PSA in the Biopsy+TURP group was not different from that of the Biopsy group. The increase in free PSA in the Biopsy group (mean 36.52 ± 21.18-fold or more) was greater than that of the TURP group (mean 15.57 ± 18.17-fold) (P = 0.0002 or less). Both total and free PSA values in the Biopsy group recovered to the initial levels 28 days after intervention (P = 0.380 and P = 0.0873, respectively). The course of both total and free PSA values in the Biopsy group was not different between prostate cancer and non-malignant disorders.
Conclusions
Extended multisite biopsies caused marked elevation of both total and free PSA compared with ordinary sextant protocol or TURP, and they reduced to the preoperative levels in about 4 weeks. The postintervention increase of PSA and its manner of recovery were comparable between the Biopsy and Biopsy+TURP groups, suggesting that the hematogenous leakage of PSA by biopsies occurs in an early phase just after biopsy and rapidly reduces also in the early phase.
aDivision of Urology, Department of Regenerative and Transplant Medicine, Graduate School of Medical and Dental Sciences, Niigata University, Niigata, Japan
bDepartment of Urology, Niigata Rousai Hospital, Niigata, Japan
cDepartment of Pathology, Niigata Rousai Hospital, Niigata, Japan
dDepartment of Urology, Johannes Gutenberg University, Mainz, Germany
ABSTRACT