Comparison of the Formula of PSA, Age, Prostate Volume and Race Versus PSA Density and the Detection of Primary Malignant Circulating Prostate Cells in Predicting a Positive Initial Prostate Biopsy in Chilean XXXX with Suspicion of @entity263 .

@entity5 @entity1 @entity263 @entity12877
BACKGROUND: Combining risk factors for @entity263 into a predictive tool may improve the detection of @entity263 while decreasing the number of benign biopsies. We compare one such tool, age multiplied by prostate volume divided by total serum PSA (PSA-AV) with PSA density and detection of primary malignant circulating prostate cells (CPCs) in a @entity263 screening program. The objectives were not only to determine the predictive values of each, but to determine the number of clinically significant @entity5 that would have been detected or missed. MATERIALS AND METHODS: A prospective study was conducted of all @entity1 undergoing 12 core ultrasound guided prostate biopsy for suspicion of @entity5 attending the Hospital DIPRECA and Hospital de Carabineros de Chile. Total serum PSA was registered, prostate volumecalculated at the moment of biopsy, and an 8 ml blood simple taken immediately before the biopsy procedure. Mononuclear cells were obtained from the blood simple using differential gel centrifugation and CPCs identified using immunocytchemistry with anti- PSA and anti- @entity12877 . Biopsy results were classed as positive or negative for @entity5 and if positive the Gleason score, number of positive cores and percent infiltration recorded. RESULTS: A total of 664 @entity1 participated, of whom 234 (35.2%) had @entity5 detected. They were older, had higher mean PSA, PSA density and lower PSA-AV. Detection of CPCs had high predictive score, sensitivity, sensibility and positive and negative predictive values, PSA-AV was not significantly different from PSA density in this population. The use of CPC detection avoided more biopsies and missed fewer significant @entity5 . CONCLUSIONS: In this screening population the use of CPC detection predicted the presence of clinically significant @entity263 better than the other parameters. The high negative predictive value would allow @entity1 CPC negative to avoid biopsy but remain in follow up. The formula PSA-AV did not add to the predictive performance using PSA density.
