Bantis Athanassios, Zissimopoulos Athanassios, Kalaytzis Christos, Giannakopoulos Stelios, Sountoulides Petros, Agelonidou Eleni, Voudalikakis Chrisostomos, Touloupidis Stavros
Urological Department, University Hospital of Alexandroupolis, K. Xenokrati 8, 681 00 Alexandroupolis, Thrace, Greece.
Hell J Nucl Med. 2007 May-Aug;10(2):138-43.
Benign prostate hyperplasia (BPH) is common in elderly men. Nevertheless, the pathophysiology of low urinary tract symptoms (LUTS) may not be due only to BPH. Many men with LUTS are submitted to unnecessary medications or surgical interventions because their symptoms have not been correctly evaluated. Can diagnostic test such as serum prostate antigen (PSA), performed by nuclear medicine techniques and the trans-abdominal ultrasound determine with high sensitivity whether LUTS is due exclusively to BPH? The aim of the study was to correlate serum PSA, prostate volume (PV), intravesical prostatic protrusion (IPP), uroflowmetry measuring maximal urine flow/sec (Qmax), and the international prostate symptom score (IPSS) questionnaire, to estimate urine bladder outlet obstruction (BOO), in patients with BPH. A hundred and twelve patients with mean of age 72 +/- 8 years and LUTS were studied. All patients were examined according to the IPSS questionnaire, had their serum PSA tested and also Qmax of prostate volume and IPP by trans-abdominal ultrasound were examined. The patients were separated in groups according to serum PSA values (<or= 1.5 ng/ml, 1.6-4 ng/ml and >or= 4.1 ng/ml), prostate volume (PV< 20.20-40 and > 20 ml) and the intravesical prostatic protrusion (IPP < 5.5-10.10 mm). There was a statistical correlation between the BOO and: a) PSA (P = 0.004), b) prostate volume with P of < 0.001) and c) IPP = 0.005. On the contrary, there was no statistical correlation between BOO and IPSS, Qmax with P values 0.228 and 0.745 respectively. Receiving operating curve (ROC) showed that patients with a serum PSA value of 1.5-4 ng/ml, IPP of type II and PV 20-40 ml, had a sensitivity of 48% for PSA, of 50% for PV and of 47% for IPP and a specificity of 75%, 47% and 60% respectively. In conclusion, according to the results of this study, a more objective evaluation of BOO, which is exclusively due to BPH, should include, not only PV but also serum PSA values and IPP.
良性前列腺增生（BPH）在老年男性中很常见。然而，下尿路症状（LUTS）的病理生理学可能并非仅由BPH引起。许多有LUTS的男性接受了不必要的药物治疗或手术干预，因为他们的症状没有得到正确评估。像通过核医学技术检测的血清前列腺抗原（PSA）以及经腹超声检查这样的诊断测试，能否高灵敏度地确定LUTS是否仅由BPH引起？本研究的目的是将血清PSA、前列腺体积（PV）、膀胱内前列腺突出（IPP）、测量最大尿流率/秒（Qmax）的尿流率测定以及国际前列腺症状评分（IPSS）问卷进行关联，以评估BPH患者的膀胱出口梗阻（BOO）情况。对112例平均年龄为72±8岁且有LUTS的患者进行了研究。所有患者均按照IPSS问卷进行检查，检测血清PSA，并通过经腹超声检查前列腺体积和IPP的Qmax。根据血清PSA值（≤1.5 ng/ml、1.6 - 4 ng/ml和≥4.1 ng/ml）、前列腺体积（PV＜20、20 - 40和＞20 ml）以及膀胱内前列腺突出（IPP＜5、5 - 10、＞10 mm）将患者分组。BOO与以下因素之间存在统计学相关性：a）PSA（P = 0.004），b）前列腺体积（P＜0.001），c）IPP（P = 0.005）。相反，BOO与IPSS、Qmax之间无统计学相关性，P值分别为0.228和0.745。受试者工作特征曲线（ROC）显示，血清PSA值为1.5 - 4 ng/ml、II型IPP且PV为20 - 40 ml的患者，PSA的灵敏度为48%，PV的灵敏度为50%，IPP的灵敏度为47%，特异性分别为75%、47%和60%。总之，根据本研究结果，对仅由BPH引起的BOO进行更客观的评估，不仅应包括PV，还应包括血清PSA值和IPP。
