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Inicio Actas Urológicas Españolas Diagnóstico precoz del cáncer de próstata en pacientes con sintomatología pr...
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Vol. 23. Issue 8.
Pages 688-693 (January 1999)
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Vol. 23. Issue 8.
Pages 688-693 (January 1999)
Diagnóstico precoz del cáncer de próstata en pacientes con sintomatología prostática mediante tacto rectal, antígeno específico prostático, ecografía tumorrectal y densidad-psa
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R. Minguez Martinez1, A. Fernandez Borrell, F. Gomez Sancha, C. Ruiz Zarate, F. Teba del pino, J.C. Romero Tejada, R. Arellano Gañan, I. Pereira Sanz
Servicio de Urología. Hospital Universitario de la Princesa. Madrid
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Resumen

Presentamos nuestra experiencia en el diagnóstico precoz del Ca. de próstata en pacientes con sintomatología de prostatismo. En el periodo de un año (96-97) se han biopsiado a 316 pacientes en base a criterios definidos en el algoritmo diagnóstico por nosotros utilizado: TR sospechoso y/o PSA ≥10 ngr/ml y en pacientes con PSA entre 4 y 10 ngr/ml cuando la Eco TR era sospechosa o bien la DPSA era ≥0,15. Hemos diagnosticado 136 Ca. de próstata (43%) con una relación biopsia ± de 1: 1,32.

Concluimos que el diagnóstico precoz en población seleccionada es útil presentando un buen rendimiento diagnóstico. Que el algoritmo diagnóstico utilizado es más que aceptable, con un 43% de biopsias positivas y una buena proporción entre biopsia ± y que la DPS con punto de corte en 0,15 es un buen método para mejorar la utilidad del PSA en pacientes dentro de la banda problemática de PSA entre 4 y 10 ngr/ml.

Palabras clave:
Cáncer de próstata
Diagnóstico precoz
Tacto rectal
PSA
Ecografía transrectal
DPSA
Abstract

Presentation of our experience in the early diagnosis of prostate cancer in patients with signs and symptoms of prostatism. Over a one year period (96-97), 316 patients underwent biopsy based on clearly defined criteria according to the diagnostic algorithm used in our centre: suspicious DRE and/or PSA ≥10 ng/mL, and in patients with PSA between 4 and 10 ng/mL in the presence of suspicious TRU or when DPSA was ≥0.15. The ratio of the 136 (43%) prostate cancer diagnosed relative to biopsy ± was 1:1.32.

It is concluded that early diagnosis in a selected population is useful and shows good diagnostic yield. The diagnostic algorithm used is more than acceptable with 43% positive biopsies and a good ratio between biopsy ±. With a cutoff of 0.15 DPSA is a good method to improve PSA significance in patients in the difficult PSA range of 4 to 10 ng/mL.

Key words:
Prostate cancer
Early diagnosis
Digital rectal examination
PSA
Transrectal ultrasound
DPSA

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