PSA seviyesi 4-10 ng/mL olan hastalarda alt üriner sistem semptomları patoloji sonucunu ön görebilir mi?
Year 2020,
Volume: 53 Issue: 2, 81 - 84, 31.08.2020
Aykut Başer
,
Cemil Aydın
,
Bilal Çelikörs
,
Hülya Yılmaz Başer
,
Mehmet Murat Baykam
,
Okan Alkış
Abstract
Amaç: Bu çalışmada PSA seviyesi 4-10 ng/mL olan hastalarda alt üriner sistem semptomalarının prostat adenokanser ve benign prostat hiperplazisini ön görecek bir parametre olup olmadığını araştırmayı amaçladık.
Gereç ve Yöntemler: 01 Haziran 2019 - 01 Şubat 2020 tarihleri arasında PSA değeri 4-10 ng/ml olan ilk kez TRUS-Bx uygulanan 75 hasta prospektif olarak çalışmaya dahil edildi. Hastaların yaş, BMI, PSA, Prostat hacmi, PSA dansitesi, uluslararası prostat semptom skorları ve uluslararası erektil fonksiyon skorları kayıt edildi. Patoloji sonucuna göre grup 1 (benign prostat hiperplazisi) ve grup 2 (prostat adenokanser) olarak hastalar 2 gruba ayrılarak belirtilen parametreler ile ilişkisi araştırıldı.
Bulgular: PSA değeri 4-10 ng/ml olan ilk kez TRUS-Bx uygulanan 75 hastanın patoloji sonucunda; 57 (%76) hastada Benign Prostat Hiperplazisi (BPH) (grup 1), 18 (%24) hastada Prostat Adenokanser (PCa) (grup 2) saptandı. İncelenen parametrelerden sadece rektal tuşe de sertlik bulgusu (p=0.001) ve IPSS skor düşüklüğü (p=0.022) Grup 2’de grup 1’e göre istatistiksel anlamlı farklılık saptandı. Yapılan korelasyon analizinde de bulgular teyit edildi.
Sonuç: PSA 4-10 ng/mL olan hastalar için IPSS skor düşüklüğü, rektal tuşe de sertlik olması kanser saptanma ihtimalini arttırmaktadır.
Supporting Institution
yok
References
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2. Pająk A, Borówka A. Prevalence of lower urinary tracts symptoms in the polish nonurban men at age 50–79 years. The first Polish community – based study. Urol Pol. 1998; Supl 1a: 10–11.
3. Taylor BC, Wilt TJ, Fink HA, Lambert LC, Marshall LM, Hoffman AR, et al. Prevalence, severity, and health correlates of lower urinary tract symptoms among older men: the MrOS study. Urology. 2006; 68: 804–809. DOI: 10.1016/j.urology.2006.04.019
4. Young JM, Muscatello DJ, Ward JE. Are men with lower urinary tract symptoms at increased risk of prostate cancer? A systematic review and critique of the available evidence. BJU Int. 2000; 85: 1037–1048. DOI: 10.1046/j.1464-410x.2000.00659.x
5. Brown CT, O'Flynn E, Van Der Meulen J, Newman S, Mundy AR, Emberton M. The fear of prostate cancer in men with lower urinary tract symptoms: should symptomatic men be screened? BJU Int. 2003; 91: 30–32. DOI: 10.1046/j.1464-410x.2003.04013.x
6. Dobruch J, Modzelewska E, Tyloch J, Misterek B, Czapkowicz E, Bres-Niewada E, et al. Lower urinary tract symptoms and their severity in men subjected to prostate biopsy. Cent European J Urol 2014; 67: 177-181. DOI: 10.5173/ceju.2014.02.art11
7. Meigs JB, Barry MJ, Oesterling JE, Jacobsen SJ. Interpreting results of prostate–specific antigen testing for early detection of prostate cancer. J Gen Intern Med. 1996; 11: 505–512. DOI: 10.1007/bf02599596
8. Lu CH, Lin TP, Shen SH, Huang YH, Chung HJ, Kuo JY, et al. Clinical efficacy of transrectal ultrasound-guided prostate biopsy in men younger than 50 years old with an elevated prostate-pecific antigen concentration (>4.0 ng/mL). Journal of the Chinese Medical Association 2017;80(7):413-418. DOI: 10.1016/j.jcma.2016.07.007
9. Frånlund M, Carlsson S, Stranne J, Aus G, Hugosson J. The absence of voiding symptoms in men with a prostate–specific antigen (PSA) concentration of ≥3.0 ng/ml is an independent risk factor for prostate cancer: results from the Gothenburg Randomized Screening Trial. BJU Int. 2012; 110: 638–643. DOI: 10.1111/j.1464-410X.2012.10962.x
10. Juszczak K. The presence of LUTS is not a decisive tool for deciding who should be qualified for prostate biopsy. Cent European J Urol 2014; 67: 182-183. DOI: 10.5173/ceju.2014.02.art12
11. Cicione A, Cormio L, Cantiello F, Palumbo IM, DE Nunzio C, Lima E, et al. Presence and severity of lower urinary tract symptoms are inversely correlated with the risk of prostate cancer on prostate biopsy. Minerva Urologica e Nefrologica 2017;69(5):486-92. DOI: 10.23736/S0393-2249.17.02737-0.
Can lower urinary tract symptoms predict pathology outcome in patients with a PSA level of 4-10 ng/mL?
Year 2020,
Volume: 53 Issue: 2, 81 - 84, 31.08.2020
Aykut Başer
,
Cemil Aydın
,
Bilal Çelikörs
,
Hülya Yılmaz Başer
,
Mehmet Murat Baykam
,
Okan Alkış
Abstract
Objective: In this study, we aimed to investigate whether lower urinary tract symptoms are a parameter to predict prostate adenocarcinoma and bening prostatic hyperplasia in patients with a PSA level of 4-10 ng / mL.
Material and Methods: 75 patients who were administered TRUS-Bx for the first time with a PSA value of 4-10 ng / ml between 01 June 2019 and 01 February 2020 were included prospectively. Age, BMI, PSA, Prostate volume, PSA density, international prostate symptom scores and international erectile function scores of the patients were recorded. According to the pathology results, patients as group 1 (bening prostatic hyperplasia) and group 2 (prostate adenocarcinoma) were divided into two groups and their relationship with the specified parameters was investigated.
Results: As a result of the pathology of 75 patients who had TRUS-Bx for the first time with a PSA value of 4-10 ng / ml; Bening Prostate Hyperplasia (BPH) (group 1) was detected in 57 (76%) patients, and Prostate Adenocarcinoma (PCa) (group 2) in 18 (24%) patients. Among the parameters examined, only the stiffness in digital rectal examination finding and IPSS score low were statistically significant in Group 2 compared to group 1. In the correlation analysis, the findings were confirmed.
Result: For patients with PSA 4-10 ng / mL, low IPSS score and rectal touch stiffness increase the chance of cancer detection.
References
- 1. Louie KS, Seigneurin A, Cathcart P, Sasieni P. Do prostate cancer risk models improve the predictive accuracy of PSA screening? A meta-analysis. Ann Oncol 2015;26:848-664. DOI: 10.1093/annonc/mdu525
2. Pająk A, Borówka A. Prevalence of lower urinary tracts symptoms in the polish nonurban men at age 50–79 years. The first Polish community – based study. Urol Pol. 1998; Supl 1a: 10–11.
3. Taylor BC, Wilt TJ, Fink HA, Lambert LC, Marshall LM, Hoffman AR, et al. Prevalence, severity, and health correlates of lower urinary tract symptoms among older men: the MrOS study. Urology. 2006; 68: 804–809. DOI: 10.1016/j.urology.2006.04.019
4. Young JM, Muscatello DJ, Ward JE. Are men with lower urinary tract symptoms at increased risk of prostate cancer? A systematic review and critique of the available evidence. BJU Int. 2000; 85: 1037–1048. DOI: 10.1046/j.1464-410x.2000.00659.x
5. Brown CT, O'Flynn E, Van Der Meulen J, Newman S, Mundy AR, Emberton M. The fear of prostate cancer in men with lower urinary tract symptoms: should symptomatic men be screened? BJU Int. 2003; 91: 30–32. DOI: 10.1046/j.1464-410x.2003.04013.x
6. Dobruch J, Modzelewska E, Tyloch J, Misterek B, Czapkowicz E, Bres-Niewada E, et al. Lower urinary tract symptoms and their severity in men subjected to prostate biopsy. Cent European J Urol 2014; 67: 177-181. DOI: 10.5173/ceju.2014.02.art11
7. Meigs JB, Barry MJ, Oesterling JE, Jacobsen SJ. Interpreting results of prostate–specific antigen testing for early detection of prostate cancer. J Gen Intern Med. 1996; 11: 505–512. DOI: 10.1007/bf02599596
8. Lu CH, Lin TP, Shen SH, Huang YH, Chung HJ, Kuo JY, et al. Clinical efficacy of transrectal ultrasound-guided prostate biopsy in men younger than 50 years old with an elevated prostate-pecific antigen concentration (>4.0 ng/mL). Journal of the Chinese Medical Association 2017;80(7):413-418. DOI: 10.1016/j.jcma.2016.07.007
9. Frånlund M, Carlsson S, Stranne J, Aus G, Hugosson J. The absence of voiding symptoms in men with a prostate–specific antigen (PSA) concentration of ≥3.0 ng/ml is an independent risk factor for prostate cancer: results from the Gothenburg Randomized Screening Trial. BJU Int. 2012; 110: 638–643. DOI: 10.1111/j.1464-410X.2012.10962.x
10. Juszczak K. The presence of LUTS is not a decisive tool for deciding who should be qualified for prostate biopsy. Cent European J Urol 2014; 67: 182-183. DOI: 10.5173/ceju.2014.02.art12
11. Cicione A, Cormio L, Cantiello F, Palumbo IM, DE Nunzio C, Lima E, et al. Presence and severity of lower urinary tract symptoms are inversely correlated with the risk of prostate cancer on prostate biopsy. Minerva Urologica e Nefrologica 2017;69(5):486-92. DOI: 10.23736/S0393-2249.17.02737-0.