Börgermann C, Loertzer H, Hammerer P, Fornara P, Graefen M, Rübben H
Klinik und Poliklinik für Urologie, Uroonkologie und Kinderurologie, Universitätsklinik Essen.
Urologe A. 2010 Feb;49(2):181-9. doi: 10.1007/s00120-010-2234-7.
The current S3 guideline for early detection of prostate cancer initiates a change to the paradigm in early detection from the detection of all prostate cancers to the identification of aggressive prostate cancers. Early detection is performed annually and starts at the age of 40 years; it should be terminated at a life expectancy of less then 10 years. The choice of the frequency of early detection should be risk adapted. The digital rectal examination is supplemented by determination of PSA. Previous to the first PSA test the patient has to be informed concerning possible consequences such as biopsy recommendation and treatment options. A threshold of 4 ng/ml is defined as an indication for prostate biopsy for the first administration. In the following early detections the PSA velocity should be considered. Today imaging methods do not play a major role in early detection of prostate cancer. Early detection identifies many latent prostate cancers and patients may receive overtreatment. The recent S3 guideline for early detection is discussed against this background on the basis of the recent literature.
当前关于前列腺癌早期检测的S3指南开启了早期检测范式的转变，从检测所有前列腺癌转变为识别侵袭性前列腺癌。早期检测每年进行一次，从40岁开始；预期寿命不足10年时应终止。早期检测频率的选择应根据风险进行调整。直肠指检辅以PSA测定。在首次进行PSA检测之前，必须告知患者可能的后果，如活检建议和治疗选择。首次检测时，4 ng/ml的阈值被定义为前列腺活检的指征。在随后的早期检测中，应考虑PSA速度。目前，影像学方法在前列腺癌早期检测中并不起主要作用。早期检测发现了许多潜伏性前列腺癌，患者可能会接受过度治疗。在此背景下，基于近期文献对最新的早期检测S3指南进行了讨论。
