Evrim Emre AKSOY, Tansu DEĞİRMENCİ, Adil Emrah SONBAHAR, Salih BUDAK, Zafer KOZACIOĞLU, BÜLENT GÜNLÜSOY, Süleyman MİNARECİ, Ali Rıza AYDER

PSA’sı 2,5-10 ng/ml arasında olan BPH tanılı hastalarda transüretral prostat rezeksiyonunun PSA, serbest/total PSA oranı, PSA dansitesi düzeyleri üzerindeki etkinliği

Amaç: Bu çalışmada PSA’sı 2,5-10 ng/mL olan hastalarda TUR-P’nin, PSA, f/t PSA oranı ve PSAD üzerindeki etkilerini inceleyerek postop dönemde bu markerların kanser taramasındaki kullanılabilirliğini değerlendirdik. Gereç ve Yöntemler: PSA değerleri 2,5-10 ng/mL arasında olan, prostat biyopsisi patolojileri benign olan, BPH tanısıyla kliniğimzde TUR-P uygulanan 50-70 yaş arası 50 erkek hasta çalışmaya dahil edildi. Hastaların preop, postop 3. ay ve postop 6. ay PSA, f/tPSA oranı ve PSAD’leri hesaplandı. Preop ölçülen prostat hacminden postop 3. aydaki prostat hacmi çıkarılarak rezeke edilen doku miktarları hesaplandı. Bu veriler kullanılarak hastaların serum PSA. f/tPSA ve PSAD’lerinin preoperatif, postoperatif 3. ay ve postoperatif 6. ay değerleri istatistiksel olarak karşılaştırıldı. Bulgular: Hastaların yaş ortalaması 61,82 ± 4,11’di. Postop 3. ay PSA değerleri, preop PSA değerlerine göre düşük olarak izlenirken aralarındaki fark istatistiksel olarak anlamlıydı p=0,041 . Benzer şekilde postop 3. ay PSAD’leri, preop PSAD’lerine göre anlamlı derecede düşük olarak izlendi p 0,001 . PSA ve PSAD’nin postoperatif 3. ve 6. ay değerleri arasında anlamlı farklılık izlenmedi p=0,348 p=0,55 . Preop, postop 3. ay ve postop 6. ay f/ tPSA oranları arasında da anlamlı bir farklılık izlenmedi p=0,954; p=0,2 . Sonuç: BPH tanısıyla TUR-P uygulanan hastalarda postop dönemde özellikle PSA ve PSAD’de düşüş olması, bu markerların bu hasta popülasyonunda kanser taraması amacı ile kullanımını sınırlamaktadır. F/T PSA oranı ise bu hasta popülasyonunda kanser taraması amacıyla kullanılabilecek güvenilir bir tetkik olarak gözükmektedir.

Anahtar Kelimeler:

BPH, PSA, TUR-P, PSAD, f/t PSA

The effect of transurethral resection of the prostate on PSA, F/T PSA Ratio and PSA Density in patients whose PSA levels are between 2,5-10 ng/mL

Objective: In this study, we aimed to evaluate the effect of the transurethral resection of the prostate on PSA, f/t PSA ratio, PSAD and the usefulness of these markers for cancer detection after the operation in patients who had 2.5-10 ng/mL PSA level.. Materials and Methods: A total of 50 patients who underwent TUR-P in our clinic were evaluated. Patients who had PSA levels between 2,5-10 ng/mL with benign pathology after needle biopsies and the age between 50-70 were included in the study. Blood PSA level, f/tPSA ratio and PSA density were calculated in preoperative period, postoperative third and sixth months. The resected prostate volumes were calculated from the difference between preoperative and postoperative third month prostate volumes. In this way the mean PSA, mean f/t PSA ratio and mean PSAD between preoperative, postoperative third and sixth month were compared. Results: Mean age value was 61,82 ± 4,11 53-69 years . Postoperative 3. month PSA and PSAD levels were lower than preoperative PSA and PSAD levels and it was statistically significant p=0,041, p 0,001 . But there was no significant difference between postoperative third and sixth month for PSA and PSAD levels p=0,348, p=0,550 . On the other hand there was no significant difference between preoperative, postoperative third and sixth month f/ tPSA ratio p=0,954; p=0,200 . Conclusion: The usefulness of the markers such as PSA and PSAD for prostate cancer detection is limited because of low levels in postoperative period. On the other hand, because of there is no change in f/tPSA ratio, this ratio can be used as a marker of cancer detection in this new population.

Keywords:

BPH, PSA, TUR-P, PSAD, f/t PSA,

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