DIAGNOSTIC VALUE OF DIGITAL RECTAL EXAMINATION, TRANSRECTAL ULTRASONOGRAPHY AND SERUM PSA IN THE DETECTION OF PROSTATE CANCER

Abstract

Currently, the incidence of advanced forms of prostate cancer (PCa) and mortality from this disease remain high in Russia. The methods of its detection are: PSA concentration in the blood serum, digital rectal examination (DRE) and transrectal ultrasonography (TRUS). Of the 56 biopsies examined, prostate cancer (PCa) was diagnosed in 78.5% cases, in 17.9% - high prostatic intraepi- thelial neoplasia (PIN) or ASAP, and 3.6% - benign prostatic hyperplasia (BPH). Our study showed that only in 77% of cases prostate cancer was detected against increased PSA level. Using 2 methods of diagnosis (PSA +DRE and PSA+TRUS) the detection rate of prostate cancer compared with mono diagnosis was not significantly increased, while significantly decreased the percentage of missed PCa for PSA / DRE combination (14.2%, p <0,05), or unchanged for the PSA / TRUS (16.1%). The best cancer positive predictive value (93.3%, p <0,05) occurred at a combination of all three factors to perform transrectal prostate biopsy.