下泌尿道症狀能否用於區分良性攝護腺肥大或是攝護腺癌
吳冠諭1，蔡育賢2，鄭鴻琳2，歐建慧2，楊文宏2，唐一清2
1國立成功大學醫學院附設醫院斗六分院
2國立成功大學醫學院附設醫院
Distinguish between benign prostatic hyperplasia and prostate cancer via lower urinary tract symptoms is possible?
Kuan-Yu Wu1, Yuh-Shyan Tsai2, Hong-Lin Cheng2, Chien-Hui Ou2, Wen-Horng Yang2, Yat-Ching Tong2
1National Cheng Kung University Hospital Dou-Liou Branch
2Department of Urology, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan
Purpose
To compare the difference between benign prostatic hyperplasia (BPH) and prostate cancer in male lower urinary tract symptoms (LUTS). This prospective study try to distinguish between BPH and prostate cancer via International Prostate Symptom Score (IPSS) in men with PSA more than 4 or digital rectal examination (DRE) revealed positive finding.
Materials and Methods
We performed a prospective analysis involving 126 male patients with PSA more than 4 or digital rectal examination (DRE) revealed positive finding from January 2012 to July 2016. All of them received PSA, rectal examination, PSA density, transrectal ultrasound (TRUS), International Prostate Symptom Score (IPSS), and TRUS-guided extended 12-core random biopsy. The exclusion criteria including PSA>100(highly malignancy rate), urinary tract infection, or Foley indwelling in half year.
Results
After histopathological evaluation, 63patients (50%) were diagnosed with BPH, while prostate cancer was detected in 63 patients (50%). Men with prostate cancer exhibited higher PSA (20.2 vs. 7.87, p=0.0001), higher PSA density (0.52 vs. 0.16, p<0.0001), and lower prostate volume (41.2 vs. 55.2, p=0.0005) than men with BPH. There was no significant difference between total IPSS, IPSS storage subgroup, or IPSS voiding subgroup except IPSS-abdominal straining to void item.
Conclusions
There was no significant difference between benign prostatic hyperplasia(BPH) and prostate cancer in male lower urinary tract symptoms(LUTS) except abdominal straining to void item when men with risk of prostate cancer. Therefore, IPSS cannot distinguish between BPH and prostate cancer in this study.