Saxena S, Mohanty N K, Jain A K
Institute of Pathology-ICMR., Safdarjang Hospital Campus, New Delhi, India.
Indian J Pathol Microbiol. 1997 Oct;40(4):441-50.
Comparison of different screening methods including digital rectal examination (DRE) and estimation of serum prostate specific antigen (PSA) had been done for detection of cancer prostate at initial stages in 186 patients presenting with prostatism. The detection rate of raised serum PSA (> 4 ng/dl) was found significantly higher than that of abnormal DRE because it could detect cases of prostate cancer at very early stages. On the other hand using abnormal DRE alone as criteria for biopsy, large number of these cases, specially at early stages, would have remained undetected (36.9%) thereby giving false low incidence. Serum PSA was found raised in pre neoplastic conditions (73.9%) like PIN and AAH also, majority of which were missed on DRE (65.2%). Raised serum PSA was found in many benign conditions (36.7%, false positive) also, hence prostatic biopsy is advised to confirm malignancy.
对186例有前列腺增生症状的患者进行了不同筛查方法的比较，包括直肠指检（DRE）和血清前列腺特异性抗原（PSA）测定，以早期检测前列腺癌。发现血清PSA升高（>4 ng/dl）的检出率显著高于直肠指检异常的检出率，因为它能在前列腺癌的极早期检测出病例。另一方面，仅将直肠指检异常作为活检标准，这些病例中的大量患者，特别是早期患者，将仍未被检测到（36.9%），从而导致发病率的错误低估。在癌前病变如前列腺上皮内瘤变（PIN）和非典型腺泡增生（AAH）中也发现血清PSA升高（73.9%），其中大多数在直肠指检时被漏诊（65.2%）。在许多良性疾病中也发现血清PSA升高（36.7%，假阳性），因此建议进行前列腺活检以确诊恶性肿瘤。
