Evaluation of the role of digital rectal examination and prostate specific antigen in diagnosis of prostate cancer

Abstract

Objectives: In this study, we examined the value of prostate specific antigen (PSA) and digital rectal examination (DRE) in prostate cancer detection among men. Materials and methods: Between January 2006 and July 2011, transrectal prostate needle biopsy was performed in 349 patients with abnormal DRE and/or >4ng/ml serum total PSA level were involved in the study. According to the histopathological examination, the patients were divided into two groups as without and with prostate cancer and their data were compared. Results: At the end of the histopathological examination, 121 (32.4%) cases had prostate cancer and 252 (67.6%) cases found without prostate cancer. Mean age and mean PSA values were higher and prostate volume was lower in the prostate cancer group than the other group. Prostate cancer was detected in 73 of the patients (66.4%) whose DRE was abnormal. In prostate cancer group, Gleason scores of 47 patients\' (38.8%) were “6”, Gleason scores of 42 patients\' (34.7%) were “ 7” and Gleason scores of 32 patients\' (26.5%) were between 8 and 10. Positive predictive values for high serum total PSA level (>4 ng/ml) and abnormal DRE were found as 39.7% and 66.4% respectively. Conclusions: Only serum total PSA measurement or only DRE is inadequate differential methods for differentiation of benign and malign prostate diseases. When DRE was assessed with serum total PSA level, cancer detection rate and reliability increases.

Keywords

• Prostate cancer, prostate biopsy, prostate specific antigen, digital rectal examination

Prostat kanseri tanısında prostat spesifik antijen ve parmakla rektal muayene bulgularının rolünün değerlendirilmesi

Öz

Amaç: Çalışmada, prostat spesifik antijen (PSA) ve parmakla rektal muayene (PRM)\'nin erkeklerde prostat kanserini saptamadaki değerini araştırdık. Gereç ve yöntem: Ocak 2006-Temmuz 2011 tarihleri arasında normal olmayan PRM ve/veya total PSA değeri 4 ng/ml üzerinde saptanan ve transrektal prostat iğne biyopsisi yapılan 373 hasta çalışmaya alınmıştır. Hastalar histopatolojik inceleme sonuçlarına göre; prostat kanseri saptanan ve saptanmayan olarak iki gruba ayrılmıştır. Her iki grubun verileri karşılaştırılmıştır. Bulgular: Histopatolojik inceleme sonucunda, 121 (%32.4) hasta prostat kanseriyken 252 (%67.6) hasta prostat kanseri değildi. Ortalama yaş ve ortalama PSA değeri prostat kanseri grubunda diğer gruba göre yüksek iken, ortalama prostat hacmi daha düşük saptandı. PRM bulguları normal olmayan 110 hastanın 73\'ünde (%66.4) prostat kanseri saptandı. Prostat kanseri grubunda, 47 hastanın (%38.8) Gleason skoru “6”, 42 hastanın (%34.7) Gleason skoru “7”, 32 hastanın (%26.5) Gleason skoru “8-10” arasında bulundu. Serum total prostat spesifik antijen (PSA) yüksekliğinin (>4 ng/ml) ve normal olmayan parmakla rektal muayene (PRM) bulgularının pozitif öngörü değerleri sırasıyla %39.7 ve %66.4 olarak bulundu. Sonuç: Serum total PSA değeri veya PRM tek başına iyi ve kötü huylu prostat hastalıklarının ayrımında yeterli değildir. PRM, serum total PSA değeri ile beraber değerlendirildiğinde kanser yakalama oranı ve güvenilirliği artmaktadır.

Anahtar Kelimeler

• Prostat kanseri, prostat biyopsisi, prostat spesifik antijen, parmakla rektal muayene

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