Central Asian Journal of Medicine


Introduction. In most developed countries, prostate cancer takes a leading place among oncological diseases. In different countries frequency of early diagnosis varies. Unfortunately, nowadays in Uzbekistan the frequency of diagnosis of prostate cancer in the late stages prevails over the early. Aim of this study was to improve the results of early diagnosis of prostate cancer by optimizing the indications for performing a prostate biopsy. Material and methods. We analyzed the results of 251 primary multifocal prostate core biopsies performed to patients who were examined in RSSPMCU in the period 2016-2019. Patients were divided into two groups: the first group included 189 patients who underwent primary prostate core biopsy; second group - 62 patients, whom performed mp-MRI and evaluated the risk of PCa by classification PI-RADS v2 before biopsy. The procedure was performed TRUS guided,under local anesthesia,using lidocaine gel (Cathejel)+periprostatic nerve block with lidocaine). Material for the study was taken with a biopsy gun BIP-high speed multi, needle 18-20 g x 20 cm. from 10-12 areas of the prostate gland in 189, with coverage of the peripheral and apical zones. In 62 patients of the second group, the same method was used to collect cores and, in addition from 2 to 4 cores were shot precisely from the zone of interest revealed by mp-MRI. Results. Among 1stgroup of 189 primary biopsies in 124 (65.6%) patients was verified adenocarcinoma. In patient with total PSA level up to 20 ng/ml indicator was 35.3%. In the 2-nd group the cancer indicator was 17.9% for the 2-3 scores of PI-RADS v2, and 91.2% for those with 4-5 scores. In patients with PSA up to 20ng/ml cancer detecting was 75% (4-5 scores). Conclusions. In the early diagnosis of prostate cancer in patients who have PSA level up to 20 ng/ml, without any suspicious according to DRE and TRUS of prostate, mp-MRI should be added to standard diagnostic scheme before primary biopsy. Among them with a risk of 2-3 scores according to PI-RADS v2 it is advisable to follow up rather than do a biopsy.

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