Detection of Prostate Cancer by Digital Rectal Examination, Serum PSA and Transrectal Ultrasonography / 대한비뇨기과학회지

ABSTRACT

PURPOSE: We designed the study to compare the efficacy of digital rectal examination(DRE), serum prostate specific antigen(PSA) & transrectal ultrasonography (TRUS) for the early detection of prostate cancer. MATERIALS AND METHODS: We analyzed the result of the prostate biopsies of 162 patients with abnormal hard nodule or asymmetricity on DRE, elevated serum PSA(> 4ng/ml) or hypoechoic lesion in peripheral zone on TRUS from August 1994 to June 1997. RESULTS: Of 162 patients, 26 patients(16%) had prostate cancer and 136 patients(84%) were diagnosed as benign prostatic hyperplasia. DRE, serum PSA and TRUS had sensitivities of 77%, 100% and 92%, respectively and positive predictive values(PPVs) of 48%, 26% and 19%, respectively. The sensitivities of high serum PSA(> 4ng/ml) with positive DRE, positive DRE with positive TRUS and high serum PSA with positive TRUS were 77%, 73% and 92%, respectively and the PPVs were 65%, 51% and 34%, respectively. In cases both DRE and TRUS were positive with high serum PSA, sensitivity and PPV were 73% and 68%, respectively CONCLUSIONS: The combination of DRE and serum PSA would be recommended as a first line examination in the diagnosis of prostate cancer regarding the sensitivity and PPV.