The relevance between the serum PSA level and the prostatic cancer biopsy detection rate after tamsulosin treatment of patients with lower urinary tract symptoms and elevated PSA level / 中华内分泌外科杂志

ABSTRACT

Objective To discuss the relevance between the serum prostate specific antigen (PSA) level and the prostatic cancer biopsy detection rate after tamsulosin treatment for patients with lower urinary tract symptoms and elevated PSA level.Methods 168 patients with lower urinary tract symptoms and elevated PSA level were divided into two groups according to the serum PSA level change after tamsulosin treatmentin the first group,serum PSA level decreased slightly (PSA≥4.0 ng/ml and PSA decrease＜20％);in the second group,serum PSA level decreased obviously (PSA＜4.0 ng/ml or PSA decrease≥20％).Tamsulosin treatment was given in 0.2 mg/d for two months.Prostate gland aspiration biopsy was performed at the end of tamsulosin treatment.Result For the 68 patients of the first group,after tamsulosin treatment,the tPSA level increased from (8.11 ±2.09)ng/ml to (9.05±3.13)ng/ml,in which 38 patients (55.88％,38/68) were confirmed as the prostatic cancer by pathology.For the 100 patients of the second group,after tamsulosin treatment,the tPSA level decreased from(7.80±3.79)ng/ml to (5.19±2.32)ng/ml,in which 6 patients (6％,6/100) was confirmed as the prostatic cancer by pathology.There was significant statistical differences of prostate aspiration biopsy detection rate between the two groups(x2=23.53,P＜0.05).For patients with lower urinary tract symptoms who received tamsulosin treatment,the sensibility of PSA increased to 86.4％,specificity increased to 75.8％,the rate of avoiding aspiration was 55.9％,and the rate of correct diagnosis was 78.5％.Conclusion Tamsulosin treatment can increase the prostatic cancer diagnostic positive rate and decrease the aspiration rate in patients with lower urinary tract symptoms and elevated serum PSA level in a certain extent.