Korean J Urol.  1994 Jan;35(1):27-32.

Role of Prostate Specific Antigen, Digital Rectal Examination and Transrectal Ultrasound in the Diagnosis of Prostate Cancer

• Park H
• Ahn HJ

Abstract

We evaluated the role of prostate specific antigen(PSA), digital rectal examination(DRE) and transrectal ultrasound(TRUS) in the diagnosis of prostate cancer. Of 93 patients with pathologically proven diagnosis, 19 patients had prostate cancer and 68 patients had BPH, while remaining 6 patients had other benign prostatic disease. Among the patients with prostate cancer, 17 patients had elevated PSA level(89%) and most of their PSA levels elevated above 10ng/ml(79%), while 2 patients with stage A disease had normal PSA level. Of 26 patients whose PSA levels were between 4 and 10microgram/ml, only 2 patients had prostate cancer(7.7%). However, these patients had significantly elevated PSA density compared to others. The positive predictive value of PSA, DRE and TRUS was 27%, 44% and 40% respectively. DRE and TRUS had 56% and 58% positive predictive value in patients with elevated PSA level in contrast to 0% positive predictive value of DRE and TRUS in patients with normal PSA level. When all three methods were combined, the positive predictive value rose to 67%. Although positive predictive value of DRE and TRUS was 44 and 40 % respectively, these methods appeared to be valuable when PSA level elevated concomitantly. Our data suggest that prostate biopsy should be performed in patients with elevated PSA level above 10ng/ml and PSA density might be valuable in patients with marginal PSA level (4-10ng/ml).

Keyword

Prostate cancer; Prostate specific antigen; Transrectal ultrasonography

MeSH Terms

Biopsy
Diagnosis*
Digital Rectal Examination*
Humans
Prostate*
Prostate-Specific Antigen*
Prostatic Diseases
Prostatic Neoplasms*
Ultrasonography*
Prostate-Specific Antigen