Transrectal Ultrasonography Guided Prostate Biopsy in Evaluating Prostate Cancer with Histopathological Evaluation and Prostate Specific Antigen Correlation

BACKGROUND Prostate cancer is the second most common cause of cancer related deaths among men in the United States. In India, prostate cancer affects 4-5 men per 100,000 population(1). Although it is a common disease, it is slow to manifest clinical signs. It is estimated that 30% of men over 45 yrs, harbor latent prostate cancer and will remain latent until death. The objective of the study was to evaluate the role of Transrectal Ultrasound (TRUS) guided biopsy with histopathological evaluation (HPE) in the detection of prostate cancer on the basis of elevated prostate-specific antigen levels (PSA). METHODS This prospective study was done on 36 patients who were referred to department of Radio-Diagnosis at Yenepoya Medical College Hospital, Mangalore for TRUS guided biopsy. TRUS guided biopsy was performed using the sextant core biopsy technique & samples were sent to the department of pathology for histopathological evaluation and results were documented. Results were analysed based on frequency and percentage. RESULTS Prostatic diseases were more common in the older age group and incidence increases with age. Most of the patients in our study had grade II prostatic enlargement. Our study showed diagnostic rate of 6 core biopsy with serum PSA levels 4-10 ng/ml was in 11.1% cases, while the diagnostic rate was 0% with serum PSA levels 11-20 ng/ml, 16.75% levels of 21-30 ng/ml, 25% with levels of 41-50 ng/ml and diagnostic rate was 100 % with serum PSA levels of >51 ng/ml, indicating strong correlation of PSA level with tumour diagnosis by TRUS guided biopsy. CONCLUSIONS TRUS guided sextant core biopsy is a safe and effective procedure in diagnosing prostate cancer and has high diagnostic rates for patients with PSA levels of >50 ng/ml and gland volume between 30-50 cc.