Research Between PSA Levels And Prostate Cancer Incidence At Biopsy After Tamsulosin Treatment In Patients With Elevated PSA

ObjectiveTo evaluate the effect of tamsulosin on reducing the serum levels of prostate-specific antigen (PSA) in patients with lower urinary tract symptoms and elevated PSA level,and explore the relationship betwen serum PSA levels and prostate cancer biopsy detection rate and its clinical significance.Material and Methods:March2011to March2013in our hospital urology clinic92cases of patients with lower urinary tract symptoms, the final84patients completed the study and included in the analysis. The inclusion criteria (1)10ng/ml<PSA level<15ng/ml or4ng/ml<PSA level≤10ng/ml and f/t≤16%(2) IPSS score≥8points (3) the maximum flow rate<15ml/s (4) rectumDRE negative⑤the urine negative⑥urinary tract B-US prostate and less obvious hypoechoic nodules.Patients receiving tamsulosin0.4mg/d,2months, after treatment all patients underwent prostate biopsy. Changes in serum PSA levels after treatment of84patients taking tamsulosin divided into two groups. Needle biopsy of the day was again measured in patients with IPSS score, serum tPSA and fPSA levels, prostate volume, urinary flow rate and residual urine, quality of life score, digital rectal examination, urine routine detection indicators.Paired sample t-test statistics of the two groups of patients with tamsulosin treatment before and after tPSA and f/tPSA changes, differences of prostate cancer biopsy detection rate of two groups used independent sample x2test statistic.Results:1. Group1(PSA≥4.0ng/ml and PSA decline<20%) of34cases after tamsulosin treatment tPSA (8.11±2.09) increased to (9.05±3.13) ng/ml,(P>0.05); f/tPSA(0.12±0.11) decreased to (0.11±0.07),(P>0.05).34patients with pathologically confirmed that19(55.88%)cases of prostate cancer, benign prostatic hyperplasia of15cases (44.12%).2. Group2(PSA<4.0ng/ml or PSA decline≥20%) of50cases after tamsulosin treatment tPSA (7.80±3.79) decreased to (5.19±2.32) ng/ml,(P <0.01); f/tPSA ratio (0.14±0.12) increased to (0.19±0.10),(P<0.01).50patients with pathologically confirmed that3(6%)cases of prostate cancer, benign prostatic hyperplasia of47cases (94%).3. After tamsulosin treatment, Group1pathologically confirmed prostate cancer19(55.88%), Group2pathologically confirmed3(6%).Two groups of prostate cancer biopsy detection rate were significantly different (x2=23.53, P<0.05), the differences of the two groups of prostate cancer detection rate was statistically significant.4. Change in PSA level after tamsulosin treatment gave a sensitivity of96.4%, specificity of75.8%, to avoid puncture rate was55.9%, and diagnostic accuracy of78.5%for prostate cancer.Conclusions:1. Patients with lower urinary tract symptoms have a certain impact on serum PSA levels after tamsulosin treatment.2. Serum PSA levels decreased after tamsulosin treatment correlate with negative prostate biopsy results; prostate biopsy diagnosed with prostate cancer in the majority of patients have no significant changes in PSA levels after tamsulosin treatment, other patients of benign prostatic hyperplasia significantly decreased.3. Patients with lower urinary tract symptoms and elevated PSA levels after tamsulosin treatment, to some extent, improve the positive rate of diagnosis of prostate cancer, reducing the rate of puncture.