Serial prostatic biopsies in XXXX with persistently elevated serum @entity1486 values.

@entity1 @entity263 @entity5 @entity1486
The objective of this study was to determine the need for repeat prostatic biopsies in @entity1 whose initial biopsy results revealed no evidence of @entity5 or atypia. We evaluated 1,136 @entity1 who underwent 1 or more prostatic biopsies in a longitudinal @entity1486 ( @entity1486 ) based @entity263 screening study that called for biopsy if the serum @entity1486 level was greater than 4.0 ng./ml. (Hybritech assay) and findings on rectal examination or ultrasonography were abnormal or suspicious for @entity5 . Of the 1,136 @entity1 who underwent prostatic biopsy 391 (34%) had @entity263 on the initial biopsy. Of 427 @entity1 who had negative initial biopsy results, a persistent serum @entity1486 level of greater than 4.0 ng./ml. and abnormal rectal or ultrasound examination findings 82 (19%) had @entity5 on biopsy 2. Of 203 @entity1 with persistent abnormalities 16 (8%) had @entity5 on biopsy 3 and 6 of 91 (7%) had @entity5 on biopsy 4 or later. Thus, 96% of the @entity5 were detected through either biopsy 1 or 2. The median initial @entity1486 level, followup @entity1486 levels and the yearly rate of change in @entity1486 were significantly greater in @entity1 whose @entity5 was detected compared with those of @entity1 whose @entity5 was not detected (6.4 versus 5.4 ng./ml., 7.4 versus 6.6 ng./ml. and 1.1 versus 0.7 ng./ml. per year, respectively). There was a trend for a higher percentage of @entity5 detected through serial screening to be pathologically organ confined with those detected through initial screening (73% versus 62%, p = 0.07). We conclude that @entity1 with a persistently elevated serum @entity1486 value after an initial negative prostatic biopsy should routinely undergo at least 1 repeat biopsy to exclude adequately the presence of detectable @entity263 .
