Transrektal ultrasonografinin prostat kanseri saptama başarı oranının serum PSA düzeylerine göre değerlendirilmesi

Amaç: Prostat kanserine için tarama çalışmalarında en geçerli yöntem serum prostat spesifik antijen (PSA) testidir. Görüntüleme yöntemleri arasında prostat kanseri tanısında en sık kullanılan yöntem transrektal ultrasonografidir (TRUS). Bu çalışmada, TRUS’un prostat kanserini saptama başarısı belirli PSA düzeylerine göre değerlendirildi. Hastalar ve Yöntem: PSA yüksekliği nedeniyle TRUS eşliğinde prostat biyopsisi alınan ve histopatolojik değerlendirmede prostat kanseri saptanan 75 olgunun TRUS bulguları retrospektif olarak incelendi. Olgular serum PSA düzeylerine göre 4.0- 9.9 ng/ml, 10- 19.9 ng/ml ve 20 ng/ml üzeri olmak üzere sınıflandırıldı. TRUS’un bu PSA düzeylerindeki kanser saptama oranları değerlendirildi. TRUS incelemeleri biplan endokaviter prob (6 MHz end-fire sektör- 7 MHz lineer) ile yapıldı. Bulgular: TRUS’un, PSA düzeyi 4.0- 9.9 ng/ml arasındaki kanser saptama oranı %33.33 olup bu oran, PSA düzeyi 10- 19.9 ng/ml arasında %44.44 ve PSA düzeyi 20.0 ve üzerinde ise %80.95’tir. TRUS’un kanser saptama oranı PSA düzeyi 20 ng/ml ve üzerinde olan grupta ilk iki gruba göre belirgin yüksekti (sırasıyla, p=0.001 ve p=0.017). Sonuç: PSA düzeyi yükseldikçe TRUS’un kanser odaklarını saptama başarısı artmaktadır. Bununla birlikte, PSA’sı 20 ng/ml’nin altındaki olgularda sistematik prostat biyopsisi uygulanmalıdır, 20 ng/ml üzerindeki PSA değerlerinde çok sayıda sistematik biyopsi yerine, TRUS’ta izlenen lezyona yönelik biyopsiler tercih edilebilir.

Evaluating the success rate of transrectal ultrasonography according to serum PSA levels

Aim: The most valid method in screening studies for prostate cancer is serum prostate specific antigen (PSA). Transrectal ultrasonography (TRUS) is the most used method in imaging studies for prostate cancer. In this study, the success of TRUS in detecting prostate cancer is assessed according to particular PSA values. Patients and Methods: TRUS findings of 75 cases, in which a TRUS-guided prostate biopsy was performed because of PSA elevation and prostate cancer was detected histopathologically, were evaluated retrospectively. All radiologic evaluations were performed via on endocavitary prob (6Mhz end-fire sector-7Mhz lineer) Results: Cancer detection rate of TRUS in PSA value between 4.0-9.9 ng/ml, 10-19.9 ng/ml and above 20 ng/ml is 33.33%, 44.44% and 80.95% respectively. Cancer detection rate of TRUS in PSA above 20 ng/ml is statistically significantly higher than the first two groups (p=0.001 and p=0.017, respectively). Conclusions: Cancer detection rate of TRUS rises as PSA value increases. Systematic prostate biopsy should be done in cases with a PSA value under 20 ng/ml, whereas biopsy intended for lesions determined in TRUS rather than systematic prostate biopsy could be preferred in cases with a PSA value above 20 ng/ml.

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