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題名 | Diagnosis of Prostate Cancer: Comparison of Serum Prostate Specific Antigen, Digital Rectal Examination and Transrectal Ultrasonography=前列腺癌之診斷:肛門指診,直腸超音波及前列腺特異抗原在前列腺癌診斷上的研究比較 |
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作者姓名(中文) | 崔克宏; 張慧朗; 王大民; 謝明里; | 書刊名 | 長庚醫學 |
卷期 | 20:1 1997.03[民86.03] |
頁次 | 頁23-28 |
分類號 | 416.275 |
關鍵詞 | 前列腺癌; 前列腺特異抗原; 經直腸超音波; 肛門指診; 病理切片; 癌症分級; Prostatic neoplasm; Prostate specific antigen; Ultrasonic diagnosis; Palpation; Biopsy; Neoplasm staging; |
語文 | 英文(English) |
中文摘要 | 背景:在前列腺癌診斷上,前列腺特異抗原常常用於前列腺癌經過治療後的追蹤檢查指標。由於前列腺特異抗原在早期前列腺癌的診斷上有它的局限性。所以我們利用肛門指診及經直腸超音波來提升早期前列腺癌的診斷。 方法:藉由回溯性研究,本文回溯長庚紀念醫院從1993年1月到1994年10月,共包括121位前列腺癌患者,平均年齡是71歲,其中有17位是接受根除性前列腺切除術。 符合病理切片的條件是(1)前列腺特異抗原大於4ng/ml,(2)肛門指診異常,(3)經直腸超音波異常。 結果:在我們的前列腺癌病人中,有17位患者(佔14%)是stage A,肛門指診檢查是正常及前列腺特異抗原平均值是8.96ng/ml,有四位患者(佔3.3%)是stage B,肛門指診檢查是小於前列腺一葉的腫塊,前列腺特異抗原平均值是32.28ng/ml,有6位患者(佔4.96%)是stage C,肛門指診檢查是小於前列腺一葉的腫塊,前列腺特異抗原平均值是48.49ng/ml。有94位患者(佔77.69%)是stage D,其肛門指診檢查是大於前列腺一葉的腫塊,前列腺特異抗原平均值是120ng/ml。在經直腸超音波檢查,有將近有19.83%的前列腺癌患者,其在超音波的表現是非特異性的。 結論:所以,我們利用肛門指診,經直腸超音波及前列腺特異抗原在前列腺癌診斷上的回溯研究比較,此三種檢查在偵測能力上,前列特異抗原是最能精確的診斷出前列腺癌,同時,如果結合肛門指診,經直腸超音波及前列腺特異抗原三種檢查,更能夠精確的診斷早期前列腺癌。 |
英文摘要 | BACKGROUND: While prostate specific antigen ( PSA )is useful as a tumor marker for montioring patients with prostate cancer after defintive therapy, limitations have been noted when it is used for early detection of prostate cancer. METHODS: We reviewed the charts of 121 patients who had undergone prostate needle biopsies, documented digital rectal examination (DRE ) and serum PSA determination before biopsy from January 1993 to October 1994. Indicuations for biopsy included abnormal DRE, PSA level greater than 4.0 ng/ml or abnormal lesions on transerectal ultrasonography (TRUS). RESULTS: Seventeen patients (14%) had stage A carcinoma with normal DRE and PSA levels from 0.1 to 34.9ng/ml (mean 9.0 ng/ml ). Four patients (3%) had stage B carcinoma with an average PSA level of 32.3ng/ml and less than one lobe indurated on DRE. Six patients (5% ) had stage C carcinoma and had an average PSA level of 48.5ng/ml and less than one lobe indurated on DRE. Ninety-four (78%) patients had stage D carcioma with an average PSA level of 120ng/ml and more than one lobe induated on DRE. While hypoechoic sectors were more than twice as likely as isoechoic sectors of the prostate to contain maliganancy on biopsy, nearly 20% of cancers were found in isoechoic sectors. CONCLUSIONS: Serum PSA is the most accurate of the three diagnostic tests evaluated. The addition of DRE or TRUS improves the detection rate of prostate ca ncer over PSA alone. |
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