| 摘要 |
Two hundred and fifty-three patients with symptoms and signs of bladder outlet obstruction or hematospermia were enrolled into this study. After obtaining blood samples for prostate-specific antigen (PSA) determination, digital rectal examination (DRE) and transrectal ultrasonography (TRUS) were used to evaluate the nature of either palpable nodule and/or hard consistency found on their prostate glands. Sono-guided core needle biopsies were performed on 59 (86.8%) of the 68 DRE-abnormal along with 40 (21.6%) of 185 DRE-normal patients who had had abnormal TRUS findings and/or elevated PSA. The detection rate of prostatic cancer (PC) from DREabnormal and DRE-normal prostates were 33.9% and 12.5%, respectively. In this study, hypoechoic lesions were found in 136 patients (53.8%). Overall, 16 (22.9%) out of the 70 biopsied patients were positive for PC, a rate which increased to 46.4 % if the PSA were greater than 10 ng/ml. Overall, the detection rate of PC for patients with PSA value<4, 4-10 and>IO ng/ml were 10.5%, 4.5% and 51.3%, respectively. The combination of a high level of serum PSA (>10 ng/ml) along with an abnormal DRE increased the PC detection rate from 33.3% to 62.5%. This experience revealed that the PC detection rate among patients with moderatξ elevation of PSA value (4-10 ng/ml) remains unexpectedly low compared to most other worldwide and similar studies. These results indicated that a PSA greater than 10 ng/ml represents an important indicator, especially when associated with abnormal DRE and/or sonographically hypoechoic lesions. |
