SÀNG LỌC UNG THƯ TUYẾN TIỀN LIỆT DỰA VÀO KẾT HỢP KHÁNG NGUYÊN ĐẶC HIỆU VỚI KHÁM TRỰC TRÀNG

Abstract

Introduction: Screening using total Prostate-Specific antigen (tPSA) or digital rectal exam (DRE) to determine referral for biopsy is a crucial requirement in prostate cancer diagnosis. However, abnormality criteria of tPSA and DRE are often applied in isolation.

Objective: This study aimed to estimate the probability of prostate cancer based on combined tPSA and DRE.

Methods: The study was conducted at MEDIC Hoa Hao Medical Center, Ho Chi Minh City, from January 2020 to April 2023 with a cross-sectional design. A total of 583 patient records aged ≥50 years with complete DRE, tPSA, and biopsy results were conveniently and continuously selected. Variables were exported from the records to data.

Resutls: Results confirmed that nodular abnormalities and increased tissue density on DRE and tPSA elevation are independent factors associated with prostate cancer. All groups with prostate nodules detected by DRE had a high probability of prostate cancer (over 80%). Notably, patients without nodular abnormalities but presenting with a rigid prostate on DRE and tPSA levels >20 ng/ml had a 100% probability of prostate cancer. In contrast, patients with normal DRE findings had a prostate cancer detection rate of <25%.

Conclusion: These findings indicate that the probability of prostate cancer is substantially influenced by the combined interpretation of DRE characteristics and tPSA levels. Integrating these variables may improve clinical decision-making regarding surveillance, further diagnostic evaluation, and biopsy referral.