Study Of The Diagnostic Value Of Serum PSA,DRE,TRUS In Patients With Prostate Carcinoma And Their Correlation

Objective:To evaluate the value of serum PSA,DRE and TRUS in diagnosis of prostate carcinoma,and to provide evidence for the early diagnosis of prostate carcinoma.Methods:The data of 113 patients with prostate adenocarcinoma in the Third Xiangya Hospital from 1997 to 2007 were studied retrospectively.All the 113 cases were diagnosed by the biopsy and staged by CT and/or MRI.The patients received serum PSA,DRE and TRUS.The data was analysed with the windows statistics software SPSS 11.5.Results:1,The age of 113 patients with prostate adenocarcinoma is from 38 to 87 years old,and the mean age is 69.81±13.21 years old.97.34%of the cases are above 50 years old.2,There are 10(8.85%),43(38.05%)and 60(53.10%)cases in G1,G2 and G3-4.There are 3(2.66%),17(15.04%),12(10.628%),81(76.68%)cases from clinical stageⅠtoⅣ. 3,Among all the 113 cases,the level of serum PSA of 111(98.23%) cases are above 4ng/ml.The ratio of fPSA/tPSA of 89(78.76%)cases are below 0.16.The PSAD of 103(91.15%)cases are above 0.15.The DRE of 98(86.73%)cases show positive finding.The TRUS of 58(51.33%) cases indicate positive description.4,The serum PSA value of 2 cases are below 4ng/ml,one is G1 and another is G3-4.The serum PSA value of 13 cases are between 4-10 ng/ml,and there are 1(7.69%),4(30.77%),8(61.54%)cases in the G1,G2,G3-4.The serum PSA value of 98 cases are above 10ng/ml,and there are9(9.18%),38(38.78%),51(52.04%)casesintheG1,G2,G3-4.5,2 cases whose serum PSA value are below 4ng/ml are diagnosed in clinical stageⅣ.The serum PSA value of 13 cases are between 4-10 ng/ml,one(7.69%)is stageⅡand the rest(92.31%)are stageⅣ.The serum PSA value of 98 cases are above 10ng/ml,and there are 3(3.06%),16(16.33%),12(12.24%),67(68.37%)eases in the clinical stageⅠtoⅣ.6,The positive rates of serum PSA combined with fPSA/tPSA,PSAD are 100%.The positive rate of PSAD combined with fPSA/tPSA is 98.23%.7,The positive rates of DRE combined with serum PSA,PSAD,fPSA/tPSA,TRUSare 100%,97.35%,92.04%,93.81%. 8,The positive rates of TRUS combined with serum PSA,PSAD,fPSA/tPSA are 99.11%,95.58%,89.38%.Conclusions:1,The age of prostate carcinoma in hospital is almost more than 50 years old.So,the male who is more than 50 years old should receive examnation termly in order to find the disease betimes.2,The prostate carcinoma is already develops to terminal carcinoma when the patients get accurate diagnosis in hospital.Therefor,in order to find the disease betimes,there should be a sieving of prostate carcinoma in the old male.At the same time,the propaganda and education of prostate carcinoma should be carried out.3,All kinds of method in the diagnosis of prostate carcinoma have their disadvantage,and there are positive correlation among serum PSA,PSAD,fPSA/tPSA,DRE,TRUS,which increases the positive rates of diagnosis in prostate carcinoma when combined with each other.4,The examination of serum PSA combined with DRE is the best method in the early diagnosis of prostate carcinoma.TRUS which is help to clinical staging and guides biopsy of the prostate plays an important role in the diagnosis of prostate carcinoma.