Repeated negative prostate biopsies with persistently elevated or rising PSA: a modern urologic dilemma.

摘要

A persistently elevated prostate-specific antigen (PSA) level is a relevant clinical matter. Anxiety toward possible prostate cancer and a late diagnosis involves both the clinician and the patient. After one or more negative biopsies, patients with elevated PSA ask insistently the reason for their abnormal findings and most often the physician has no definite answer. Even the definition of elevated PSA may be confusing and there is no universally accepted cut-off point because adaptation to the patient's age and prostate volume has been advocated for several years. The free-to-total PSA ratio is another tool for making PSA more sensitive.