Evaluation of the role of digital rectal examination and transrectal ultrasonography in diagnosis of prostate cancer in Turkish men

Abstract

AimInvestigation of the relationship between Prostate Specific Antigen (PSA) and digital rectal examination(DRE) and transrectal ultrasonography(TRUS) findings in different prostate pathologies.Methods12-quadrant prostatic biopsy was performed for 229 patients who were admitted to our outpatient clinic between August 2008-January 2009, with lower urinary tract symptoms (LUTS) and PSA levels over 4 ng/ml. Histopathological evaluation were as benign adenomatous hyperplasia (BPH) in 91, BPH with chronic prostatitis in 60 and adenocarcinoma in 63 patients. PSA levels between 4.0 and 9.9 ng/ml and PSA level higher than10 ng/ml were determinated as Group1 and Group 2. The relationship between pathologic diagnosis and DRE /TRUS findings were evaluated.ResultsWhile the determination of toughness in DRE didn’t show any difference in terms of pathological diagnosis in group-1, the rate of toughness in group-2 was higher in favor of PCa. In 3 patients, there was nodule in DRE and PSA was below 10ng/ml, 2 of them were diagnosed as BPH and the other one was diagnosed as PCa. PSA was above 9.9ng/ml in other 3 patients and all of them were diagnosed as PCa. While there was no statistically significant relationship between pathologic results and positive or negative TRUS findings in group-1, group-2 had statistically significant relationship.ConclusionTRUS and DRE are more valuable tests for PCa diagnosis but these tests effectiveness is related to PSA.

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