Diagnostic Value of Ultrasound-Guided Prostate Biopsy in the Detection of Clinically Significant Prostate Cancer
DOI:
https://doi.org/10.70577/asce.v4i4.536Keywords:
Prostate cancer; Prostate biopsy; Gleason / ISUP; EcuadorAbstract
Prostate cancer is the second most frequently diagnosed malignancy in men and one of the leading causes of male cancer-related mortality worldwide. Prostate biopsy remains the fundamental diagnostic method to confirm the disease and determine its aggressiveness through the Gleason score and ISUP prognostic groups. However, local data in Ecuador are scarce, limiting the adaptation of diagnostic and therapeutic protocols to national needs. To address this gap, a retrospective observational study was conducted including 73 prostate biopsies obtained between 2022 and 2023 from the diagnostic centers Cendiamed and Urolaser Medical, processed at IpathLab (Ecuador). Clinical variables (age, PSA, bilaterality) and histopathological variables (lobe-specific diagnosis, Gleason, ISUP, tumor burden) were analyzed. Descriptive statistics, bivariate tests (Mann–Whitney U, Chi²), and binary logistic regression were applied to identify predictors of clinically significant prostate cancer (csPCa, defined as ISUP ≥2).
The mean age was 64.4 ± 8.5 years. Median PSA was 9.9 ng/mL (IQR: 8.1–13.9), with most patients within the 4–10 ng/mL (46.6%) and >10 ng/mL (47.9%) categories. Adenocarcinoma was detected in 49.3% of cases and csPCa in 31.5%. ISUP distribution showed that groups 1 and 2 were the most frequent, although high-risk cases (ISUP 4–5) were also identified. In bivariate analysis, bilaterality was significantly associated with csPCa (p=0.009), while PSA showed no significant association (p=0.35). Logistic regression identified age (OR=1.14; 95% CI: 1.01–1.28; p=0.033) and tumor burden percentage (OR=1.045; 95% CI: 1.004–1.087; p=0.031) as independent predictors of csPCa.
This study achieved its objective of characterizing the histopathological findings of prostate biopsies in Ecuador, demonstrating that age and tumor burden are key factors for predicting clinically significant prostate cancer, whereas PSA alone showed limited diagnostic value. These results provide novel evidence for the Ecuadorian setting and underscore the importance of generating local data to strengthen urological and pathological practice, promoting more precise and human-centered clinical decision-making.
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