Detection of prostatic cancer using digital rectal examination, prostate-specific antigen and transrectal ultrasonography

T. S. Tzai, J. S.N. Lin, Y. C. Yeh, Nan-Haw Chow

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Abstract

Two hundred and fifty-three patients with symptoms and signs of bladder outlet obstruction or hematospermia were enrolled into this study. After obtaining blood samples for prostate-specific antigen (PSA) determination, digital rectal examination (DRE) and transrectal ultrasonography (TRUS) were used to evaluate the nature of either palpable nodule and/or hard consistency found on their prostate glands. Sono-guided core needle biopsies were performed on 59 (86.8%) of the 68 DRE-abnormal along with 40 (21.6%) of 185 DRE-normal patients who had had abnormal TRUS findings and/or elevated PSA. The detection rate of prostatic cancer (PC) from DREabnormal and DRE- normal prostates were 33.9% and 12.5%, respectively. In this study, hypoechoic lesions were found in 136 patients (53.8%). Overall, 16 (22.9%) out of the 70 biopsied patients were positive for PC, a rate which increased to 46.4% if the PSA were greater than 10 ng/ml. Overall, the detection rate of PC for patients with PSA value<4, 4-10 and >10 ng/ml were 10.5%, 4.5% and 51.3 %, respectively. The combination of a high level of serum PSA (>10 ng/ml) along with an abnormal DRE increased the PC detection rate from 33.3% to 62.5%. This experience revealed that the PC detection rate among patients with moderate elevation of PSA value (4-10 ng/ml) remains unexpectedly low compared to most other worldwide and similar studies. These results indicated that a PSA greater than 10 ng/ml represents an important indicator, especially when associated with abnormal DRE and/or sonographically hypoechoic lesions.

Original languageEnglish
Pages (from-to)97-101
Number of pages5
JournalJournal of Surgical Association Republic of China
Volume29
Issue number2
Publication statusPublished - 1996 Dec 1

All Science Journal Classification (ASJC) codes

  • Surgery

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