Trans rectal ultra sound guided prostate biopsies: a single centre experience in Sri Lanka.

Department of Pathology, Faculty of Medicine, University of Colombo, Sri Lanka.
Ceylon Medical Journal 04/2009; 54(1):6-9. DOI: 10.4038/cmj.v54i1.465
Source: PubMed

ABSTRACT Trans rectal ultrasound guided prostate biopsy (TRUS) was introduced to Sri Lanka in 2002.
1. To study clinicopathological features of males subjected to TRUS biopsy 2. To compare estimation of tumour burden by two methods in carcinoma prostate (CaP).
749 symptomatic males subjected to TRUS biopsy over 64 months at a single centre. Information was retrieved from case records. Tumour burden in CaP was calculated as: 1. Calculated tumour burden (CTB)--total percentage tumour in each core/total number of cores 2. Percentage positive biopsy cores (PPBC)--number of positive cores/total number of cores X 100. SPSS 15.0, student's t test and Spearman's rank correlation coefficients were used for statistical analysis.
35.2% had CaP, microacinar in type. 34.88% were poorly differentiated. CaP was frequent among older patients (P<0.00001). The prostate volume in CaP was significantly lower than in the benign group (P<0.05). Prostate specific antigen (PSA) level was significantly higher in CaP (P<0.00001). A 99.6% sensitivity and 4.7% specificity was observed at PSA of 4 ng/ml for detecting CaP. Specificity was 98% at 25.5 ng/ml, with a sensitivity of 44.4%. CTB and PPBC had similar correlations with biochemical/histological parameters of CaP and were strongly correlated (0.786).
Males with CaP were older, had higher PSA levels and smaller prostates. A cut off level of PSA >4 ng/ml could be used for directing symptomatic patients for TRUS biopsy to detect CaP, keeping in mind that specificity is 98% only at 25.5 ng/ml. Both CTB and PPBC could be used to calculate tumour burden in TRUS with CaP.

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    ABSTRACT: Background: Prostatic enlargement is a common cause of bladder outlet obstruction in men in Nigeria. Malignant enlargements must be differentiated from benign enlargements for adequate treatment of each patient. High serum total prostate-specific antigen (tPSA) levels suggest malignancy, but some of the biopsies done due to a serum tPSA value 4 ng/mL would be negative for malignancy because of the low specificity of tPSA for prostate cancer. This study aims to compare the histologic findings of all prostate specimens obtained from core needle biopsy, open simple prostatectomy, and transurethral resection of the prostate with the respec- tive serum tPSA values in an attempt to decipher the role of serum tPSA in the management of these patients. Methods: The case notes of patients attended to from April 2009 to March 2012 were ana- lyzed. Essentially, the age of the patient, findings on digital rectal examination, abdominopelvic ultrasonography report on the prostate, serum tPSA, and histology reports from biopsy or prostatectomy specimens as indicated were extracted for analysis. Results: The relationship between age, findings on digital rectal examination, serum tPSA, abdominopelvic ultrasonography report, and histology are compared. A statistically significant relationship existed between a malignant histology and age 65 years and older, suspicious findings on digital rectal examination, suspicious ultrasonography findings, and serum tPSA 10 ng/mL, but not tPSA 4 ng/mL. Conclusion: In Nigerian patients with symptomatic prostate enlargement, serum tPSA should be seen as a continuum with increasing risk of prostate malignancy. Keywords: serum total prostate-specific antigen, symptomatic prostate enlargement, prostate histology
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    Sri Lanka Journal of Urology. 11/2010; 10(1).
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    ABSTRACT: Prostatism is a common malady in the geriatric age group. Benign prostatic hyperplasia and Carcinoma of the prostate are increasingly frequent with advancing age. The aim of the present study is to study the spectrum of prostatic lesions among the biopsies received in a rural hospital.
    Journal of clinical and diagnostic research : JCDR. 09/2014; 8(9):FC04-6.


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