OUTCOME OF TRANS RECTAL ULTRASOUND GUIDED TWELVE CORE BIOPSY OF PROSTATE FOR THE DETECTION OF PROSTATE CANCER- A SINGLE CENTER EXPERIENCE

Authors

  • Muhammad Waqas Shifa International Hospital Islamabad
  • Durre Shohab Shifa International Hospital Islamabad
  • Mohammad Athar Khawaja Shifa International Hospital Islamabad
  • Afifa Masood Shifa International Hospital Islamabad
  • Muhammad Waqas Iqbal Shifa International Hospital Islamabad
  • Saeed Akhter Shifa International Hospital Islamabad

Abstract

Background: This study was conducted to determine the outcome of trans-rectal ultrasound (TRUS) guided biopsy of prostate for the detection of prostatic carcinoma in a single tertiary care hospital in Pakistan. Methods: This is a retrospective study including three hundred and eighty-three patients who underwent trans rectal ultrasound guided biopsy of prostate in a single tertiary care hospital. Indications for biopsy were raised prostate specific antigen (PSA), abnormal digital rectal examination (DRE) and/or both. Twelve core biopsy of prostate was done. Results: The overall detection rate of prostate cancer was 59%. Prostate cancer detection in various PSA ranges of 0-3.99, 4–9.99, 10–19.99 and >20 ng/ml are 22.22%, 37.88%, 50.0% and 89.9%. PSA density >0.15ng/ml2 can diagnose 74.5% of patients with cancer. Prostate cancer detection rate based on abnormal DRE is 64.6% compared to 60.8% detected by PSA>4 ng/ml. Conclusion: In conclusion raised PSA, smaller prostate volume, abnormal DRE and raised PSA density are associated with greater chances of detection of prostate carcinoma.Keywords: Digital rectal examination; Prostate cancer; Prostate Specific antigen; Prostate volume, Trans rectal ultrasound

Author Biographies

Muhammad Waqas, Shifa International Hospital Islamabad

Post graduate Resident Urology department Shifa international Hospital Islamabad

Durre Shohab, Shifa International Hospital Islamabad

Assistent consultant  Urology department Shifa international Hospital Islamabad

Mohammad Athar Khawaja, Shifa International Hospital Islamabad

consultant  Urology department Shifa international Hospital Islamabad

Afifa Masood, Shifa International Hospital Islamabad

Post graduate trainee  Urology department Shifa international Hospital Islamabad

Muhammad Waqas Iqbal, Shifa International Hospital Islamabad

Post graduate trainee  Urology department Shifa international Hospital Islamabad

Saeed Akhter, Shifa International Hospital Islamabad

Consultant  Urology department Shifa international Hospital Islamabad

References

Obort AS, Ajadi MB, Akinloye O. Prostate-specific antigen: any successor in sight? Rev Urol 2013;15(3):97–107.

Bhurgri Y. Epidemiology of cancers in Karachi (1995-1999). Karachi Pharm Upjohn 2001;59–66.

Nazir B. Pain during Transrectal Ultrasound-Guided Prostate Biopsy and the Role of Periprostatic Nerve Block: What Radiologists Should Know. Korean J Radiol 2014;15(5):543–53.

Hwang SI, Lee HJ. The future perspectives in transrectal prostate ultrasound guided biopsy. Prostate Int 2014;2(4):153–60.

Lin YT, Wei XH, Uhlman M, Lin XT, Wu SF, Diao PF, et al. PSA density improves the rate of prostate cancer detection in Chinese men with a PSA between 2.5–10.0 ng ml-1 and 10.1–20.0 ng ml-1: a multicenter study. Asian J Androl 2015;17(3):503–7.

Wade J, Rosario DJ, Howson J, Avery KN, Salter CE, Goodwin ML, et al. Role of information in preparing men for transrectal ultrasound guided prostate biopsy: a qualitative study embedded in the ProtecT trial. BMC Health Serv Res 2015;15:80.

Thompson IM, Pauler DK, Goodman PJ, Tangen CM, Lucia MS, Parnes HL, et al. Prevalence of prostate cancer among men with a prostate specific antigen level < or =4.0 ng per milliliter. N Engl J Med 2004;350(22):2239–46.

Haese A, Graefen M, Palisaar J, Huland E, Huland H. Serum markers for early detection and staging of prostate cancer. Status report on current and future markers. Urologe A 2003;42(9):1172–87.

Benson MC, Whang IS, Pantuck A, Ring K, Kaplan SA, Olsson CA, et al. Prostate specific antigen density: a means of distinguishing benign prostatic hypertrophy and prostate cancer. J Urol 1992;147(3 Pt 2):815–6.

Rashid R, Mubarak M. Frequency of adenocarcinoma in transrectal ultrasound-guided prostate needle biopsies in men with clinical suspicion of prostate cancer and raised serum prostate specific antigen. Middle East J Cancer 2013;4(2):73–8.

Kash DP, Lal M, Hashmi AH, Mubarak M. Utility of Digital Rectal Examination, Serum Prostate Specific Antigen, and Transrectal Ultrasound in the Detection of Prostate Cancer: A Developing Country Perspective. Asian Pac J Cancer Prev 2014;15(7):3087–91.

Lee A, Chia SJ. Contemporary outcomes in the detection of prostate cancer using transrectal ultrasound-guided 12-core biopsy in Singaporean men with elevated prostate specific antigen and/or abnormal digital rectal examination. Asian J Urol 2015;2(4):187–93.

Al Rumaihi K, Al Jalham K, Younes N, Majzoub AA, Shokeir AA. The role of an abnormal prostate-specific antigen level and an abnormal digital rectal examination in the diagnosis of prostate cancer: a cross-sectional study in Qatar. Arab J Urol 2013;11(4):355–60.

Teoh JY, Yuen SK, Tsu JH, Wong CK, Ho BS, Ng AT, et al. Prostate cancer detection upon transrectal ultrasound-guided biopsy in relation to digital rectal examination and prostate-specific antigen level: what to expect in the Chinese population? Asian J Androl 2015;17(5):821–5.

Werahera PN, Sullivan K, La Rosa FG, Kim FJ, Lucia MS, O’Donnell C, et al. Optimization of prostate cancer diagnosis by increasing the number of core biopsies based on gland volume. Int J Clin Exp Pathol 2012;5(9):892–9.

Baruteuoglu B, Bozdemir AE, Ertan Y, Kabaroğlu C, Tamsel S, Hekimgil M, et al. Performance of total prostate specific antigen and free prostate specific antigen ratio for screening prostate cancer in Turkish population. Turkish J Cancer 2009;39(1):18–24.

Tanaka N, Shimada K, Nakagawa Y, Hira S, Watanabe S, Miyake M, et al. The optimal number of initial prostate biopsy cores in daily practice: a prospective study using the Nara Urological Research and Treatment Group nomogram. BMC Res Notes 2015;8:689.

Vis AN, Hoedemaeker RF, Roobol M, Van der Kwast TH, Schroder FH. Tumor characteristics in screening for prostate cancer with and without rectal examination as an initial screening test at low PSA(0.0-3.9ng/ml). Prostate 2001;47(4):252–61.

Kim YM, Park S, Kim J, Park S, Lee JH, Ryu DS, et al. Role of Prostate Volume in the Early Detection of Prostate Cancer in a Cohort with Slowly Increasing Prostate Specific Antigen. Yonsei Med J 2013;54(5):1202–6.

Tang P, Jin XL, Uhlman M, Lin YR, Deng XR, Wang B, et al. Prostate volume as an independent predictor of prostate cancer in men with PSA of 10-50 ng ml−1. Asian J Androl 2013;15(3):409–12.

Wu YS, Na R, Xu JF, Bai PD, Jiang HW, Ding Q. The influence of prostate volume on cancer detection in the Chinese population. Asian J Androl 2014;16(3):482–6.

Hwang I, Kim SY, Cho JY, Lee MS, Kim SH. The diagnostic ability of an additional midline peripheral zone biopsy in transrectal ultrasonography-guided 12-core prostate biopsy to detect midline prostate cancer. Ultrasonography 2016;35(1):61–8.

Catalona WJ, Richie JP, deKernion JB, Ahmann FR, Ratliff RL, Dalkin BL, et al. Comparison of prostate specific antigen concentration versus prostate specific antigen density in the early detection of prostate cancer: receiver operating characteristic curves. J Urol 1994;152(6 Pt 1):2031–6.

Al-Abdin OZ, Rabah DM, Badr G, Kitb A, Aprikian A. Differences in prostate cancer detection between Canadian and Saudi populations. Braz J Med Biol Res 2013;46(6):539–45.

Benson MC, Whang IS, Olsson CA, McMahon DJ, Cooner WH. The use of prostate specific antigen density to enhance the predictive value of intermediate levels of serum prostate specific antigen. J Urol 1992;147(3 Pt 2):817–21.

Zheng XY, Xie LP, Wang YY, Ding W, Yang K, Shen HF, et al. The use of prostate specific antigen (PSA) density in detecting prostate cancer in Chinese men with PSA levels of 4‑10 ng/ml. J Cancer Res Clin Oncol 2008;134(11):1207–10.

Sasaki R, Habuchi T, Sato K, akao T, Kakinuma H, Zhang LQ, et al. The Clinical Utility of Measuring Total PSA, PSA Density, γ-Seminoprotein and γ-Seminoprotein/Total PSA in PCa Prediction. Jpn J Clin Oncol 2000;30(8):337–42.

Kam SC, Choi SM, Yoon S, Choi JH, Lee SH, Hwa JS, et al. Complications of Transrectal Ultrasound-Guided Prostate Biopsy: Impact of Prebiopsy Enema. Korean J Urol 2014;55(11):732–6.

Gonzalez CM, Averch T, Boyd LA, Clemens J, Dowling R, Goldman H. AUA/SUNA White Paper on the Incidence. Prev Treat Complicat Relat Prostate Needle Biopsy. Am Urol Assoc 2012.

Chiang IN, Chang SJ, Pu YS, Huang KH, Yu HJ, Huang CY. Major complications and associated risk factors of transrectal ultrasound guided prostate needle biopsy: a retrospective study of 1875 cases in taiwan. J Formos Med Assoc 2007;106(11):929–34.

Published

2017-12-27

Issue

Vol. 30 No. 1 (2018): JOURNAL OF AYUB MEDICAL COLLEGE, ABBOTTABAD

Section

ORIGINAL ARTICLE

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