Sivaraman Ananthakrishnan, Bhat Kulthe Ramesh Seetharam
Department of Urology, No. 21, Greams Lane, Off. Greams Road, Chennai, Tamil Nadu India.
Indian J Surg Oncol. 2017 Jun;8(2):160-168. doi: 10.1007/s13193-016-0584-3. Epub 2017 Jan 23.
Screening of prostatic cancer is a matter of debate among uro-oncologist. With many new screening modalities like prostatic health index (PHI), 4K testing the role of screening has increased as one is able to stratify patients with serum prostate specific antigen level in a grey zone of 4-10 ng/ml and normal digital rectal examination into various risk groups, thus avoiding unnecessary biopsy which was the pitfalls of routine screening practice. PHI is better at predicting malignancy while 4K is better at predicting high-grade disease. This in combination with multiparametric MRI especially with prostate imaging reporting and data system score has made screening less difficult and more meaningful for a practising uro-oncologist.
前列腺癌筛查是泌尿肿瘤学家之间存在争议的问题。随着许多新的筛查方式,如前列腺健康指数(PHI)、4K检测的出现,筛查的作用有所增加,因为能够将血清前列腺特异性抗原水平处于4至10 ng/ml灰色区域且直肠指检正常的患者分层到不同风险组,从而避免了常规筛查实践中的陷阱——不必要的活检。PHI在预测恶性肿瘤方面表现更好,而4K在预测高级别疾病方面表现更好。这与多参数MRI,尤其是前列腺影像报告和数据系统评分相结合,使得筛查对于执业泌尿肿瘤学家来说不那么困难且更有意义。