The Pathological Features Of Mass Screening For Prostate Cancer In The Population With Serum Prostate Specific Antigen Level Less Than 4.0ng/ml

Objectives:To investigate the pathological features of prostate cancer in the populationwith serum prostate specific antigen level less than 4.0ng/ml.Materials and methods:This study included 46 men who underwent prostate biopsy in the massscreening for prostate cancer in CHANGCHUN of China, and their serumprostate specific antigen levels were all less than 4.0ng/ml. We evaluatedtheir pathology and epidemiology features by means of histopathology ,immunohistochenistry and statistics methods.Results:(1)The average age of 46 men was 61.70 ± 13.32 years, and theproportion in men age less than 45, 45 to 54, 55 to 64, 64 to 74, 75years ormore,were10.9(5/46)15.2(7/46),19.6(9/46),41.3(19/46),13.0%(6/46).(2)The serum PSA of the 46 men ranged 0.03 from 3.84 ng/ml,.The mainattribution of PSA level was 0-1.9 ng/ml(60.9%).(3)The most case of 46 men was benign prostate hyperplasia(29,63%);The second was prostate cancer (10, 28.3%).Others wereinflammation(3, 7%),sarcoma(3, 7%)and metastasis cancer(1, 2%).(4) The moderately differentiated(3/5),clinically localized(4/5)adenocarcinoma(4/5)and special type prostate cancer were the main type of the prostatecancer with serum PSA less than 4.0ng/ml.(5 ) The digital rectal examination of 46 cases were all abnormal, and thepositive predictive value of a suspicious digital rectal examination was15.4 % ,13.3 % , 25%, 40% in men with PSA 0 to 0.9, 1.0 to 1.9, 2.0 to2.9.and 3.0 to 4.0 ng/ml. Cancer was detected in 10(21.7%) of the 46men.Conclusions;(1) Prostate cancer patients are existence in the population with serumPSA< 4.0ng/ml.(2) The moderately differentiated ,clinically localized adenocarcinomaand special type prostate cancer are the main type of the population withserum PSA< 4.0ng/ml.(3) The detection rate of prostate cancer in the serum PSA level 2.0-4.0ng/ml is relative higher.(4) DRE is very important for the detection of prostate cancer with serumPSA < 4.0ng/ml.As a result, prostate cancer patients are existence in the population withserum PSA< 4.0ng/ml, and often were neglected then missing theopportunity of treatment. So a good knowledge of the pathological featuresfor prostate cancer with serum prostate specific antigen level less than4.0ng/ml is very important. It not only can increase the detection rate ofprostate cancer ,as well as provides the theory sport for the mass screeningdevelopment in China.