Oeda Tadashi, Kusumi Norihiro, Takamoto Atsushi
Department of Urology, Onomichi Municipal Hospital.
Nihon Hinyokika Gakkai Zasshi. 2010 Jan;101(1):18-24. doi: 10.5980/jpnjurol.101.18.
The usefulness of the screening for prostate cancer with prostate specific antigen (PSA) in the medical checkup ("Human Dock") at Onomichi Municipal Hospital was evaluated.
From April 1997 to December 2007, serum PSA of 1,234 male (median age: 59) was measured in the medical checkup and each parameter of screening was evaluated. In addition, for the cases with prostate cancer, results of treatment and clinical significance were assessed.
PSA was elevated in 82 cases (6.6%), aged 42-87 (median 64), in which PSA varied 3.1-66.5 ng/ml (median 5.4). Trans-rectal biopsy was performed in 35 cases and prostate cancer was detected in 15 (42.9% of biopsied cases and 1.2% of whole group), aged 58-81 (median 70), with PSA value 4.2-66.5 ng/ml (median 10.3). Clinical stage of these cases was cT1cN0M0 in 12 and cT2aN0M0 or more in 3, Gleason score was 3 + 3 in 4 and 3 + 4 or more in 11. Initial treatment was radical prostatectomy in 12, androgen-deprivation therapy in 2 and external beam irradiation in 1. During the follow-up for 8-107 months (median 60), 14 were alive with good control and 1 was alive with relapse. Only one case was "clinically insignificant" cancer (impalpable and localized and tumor volume less than 0.5 ml and Gleason score 3 + 3 or less).
Most of the prostate cancers detected in the medical checkup were clinically significant, therefore, PSA screening doesn't result in overtreatment and it is meaningful to perform PSA screening in the medical checkup.
评估尾道市立医院体检（“人体码头”）中前列腺特异性抗原（PSA）筛查前列腺癌的效用。
1997年4月至2007年12月期间，对1234名男性（中位年龄：59岁）进行了体检血清PSA检测，并评估了各项筛查参数。此外，对于前列腺癌病例，评估了治疗结果和临床意义。
82例（6.6%）PSA升高，年龄42 - 87岁（中位年龄64岁），PSA值在3.1 - 66.5 ng/ml之间（中位值5.4）。对35例进行了经直肠活检，其中15例（活检病例的42.9%，全组的1.2%）检测到前列腺癌，年龄58 - 81岁（中位年龄70岁），PSA值4.2 - 66.5 ng/ml（中位值10.3）。这些病例的临床分期为cT1cN0M0的有12例，cT2aN0M0及以上的有3例，Gleason评分3 + 3的有4例，3 + 4及以上的有11例。初始治疗为根治性前列腺切除术的有12例，雄激素剥夺治疗的有2例，外照射放疗的有1例。在8 - 107个月（中位值60个月）的随访期间，14例病情得到良好控制存活，1例复发存活。仅1例为“临床意义不显著”的癌症（不可触及、局限、肿瘤体积小于0.5 ml且Gleason评分3 + 3或更低）。
体检中检测到的大多数前列腺癌具有临床意义，因此，PSA筛查不会导致过度治疗，在体检中进行PSA筛查是有意义的。
