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하부요로증상으로 내원한 환자에서 전립선특이항원이 증가된 경우 전립선생검의 필요성

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Author(s)
정영철장혁수김천일Young Churl ChungHyuk Soo ChangChun Il Kim
Keimyung Author(s)
Chang, Hyuk SooKim, Chun Il
Department
Dept. of Urology (비뇨의학)
Journal Title
대한비뇨기과학회지
Issued Date
2005
Volume
46
Issue
2
Abstract
Purpose: To determine the criteria that can be used to safely reduce unnecessary biopsies for patient found to be lower urinary tract symptoms (LUTS)/benign prostatic hyperplasia (BPH) negative on digital rectal examination (DRE) and transrectal ultrasound (TRUS), with a prostate specific antigen (PSA) level over 4.0ng/ml.
Materials and Methods: A retrospective data analysis of 157 patients, with a raised serum PSA level, over 4.0ng/ml, and negative DRE and TRUS findings was performed. The detection rates of prostate cancer according to the prostate volume were also investigated. All patients with one benign biopsy were followed with PSA determination over a 2 year period, and in the cases of men with a persistently elevated PSA, a re-biopsy was suggested. Patients were also classified according to the results of the first biopsy and the follow up PSA level.
Results: Of the 157 patients, the rate of prostate cancer was 14.6% (23 of 157), and that for a benign disease, including BPH, was 85.4% (134 of 157). The rates of prostate cancer according to prostate volume (PV) were 20.6 (22 of 107) and 2.0% (1 of 50) in those with a PV≤80ml and >80ml, respectively. In the men with one benign biopsy, cancer was not found in 61 (23 with a prostatectomy and 38 with a re-biopsy) and 112/134 (83.6%) had normalized PSA after 1 year.
Conclusions: A statistically significant difference was noted in the profile of a prostate biopsy for cancer according to the prostate volume. We concluded that the majority of LUTS/BPH men with a prostate volume over 80ml have PSA elevation due to BPH or another benign prostate disease, not related to cancer. For patients with negative DRE and TRUS findings, a large prostate (>80ml) and elevated prostate-specific antigen (PSA), over 4ng/ml, watchful waiting, with PSA follow up and BPH treatment, may be a suitable option. (Korean J Urol 2005;46:112-117)
Alternative Title
The Necessity of Prostate Biopsy for Patient of LUTS/BPH with Elevated Serum Prostate Specific Antigen
Keimyung Author(s)(Kor)
장혁수
김천일
Publisher
School of Medicine
Citation
정영철 et al. (2005). 하부요로증상으로 내원한 환자에서 전립선특이항원이 증가된 경우 전립선생검의 필요성. 대한비뇨기과학회지, 46(2), 112–117.
Type
Article
ISSN
2005-6737
URI
https://kumel.medlib.dsmc.or.kr/handle/2015.oak/38811
Appears in Collections:
1. School of Medicine (의과대학) > Dept. of Urology (비뇨의학)
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