Comparative Study on Diagnostic Value of Digital Rectal Examination, Serum Prostate Specific Antigen and Transrectal Ultrasound in Prostate Cancer / 대한비뇨기과학회지

ABSTRACT

We analysed 101 patients with voiding symptoms of suggestive prostatism to evaluate the diagnostic values of digital rectal examination (DRE), serum prostate specific antigen (PSA) and transrectal ultrasonography (TRUS) in the detection of prostate cancer. Final diagnoses confirmed histopathologically by TRUS-guided needle biopsy resulted in 31 prostate cancers. The prostate cancer detection rates by DRE, PSA (>2.5 ng/ml) and TRUS were 47.5%, 34.1% and 48.1%, respectively. Sensitivity and specificity of DRE, TRUS and serum PSA were 90%, 40%, 81%, 42.9% and 100%, 14.3% respectively. Especially PSA had too low specificity in discrimination of malignant diseases from the benign. Three out of 31 patients with prostate cancer showed only one abnormal findings from three items. Patients with abnormal findings in DRE-PSA, TRUS-PSA and DRE-TRUS showed the detection` rates of cancer 57.1%, 54.3% and 62.5% respectively. The detection rate was highest as 73.5% when patients showed abnormal findings in all three items. Our results suggest that the combination of DRE, TRUS and serum PSA increased the detection rate of cancer but several points such as cost-effectiveness and efforts to increase specificity methodologically should be taken into consideration before we apply those diagnostic modalities to screening of prostate cancers as routine procedures.