THE DIAGNOSTIC-ACCURACY OF DIGITAL RECTAL EXAMINATION, TRANSRECTAL ULTRASONOGRAPHY, PROSTATE-SPECIFIC ANTIGEN (PSA) AND PSA DENSITY IN PROSTATE CARCINOMA

Objective To evaluate the efficacy of digital rectal examination (DRE) , transrectal ultrasonography (TRUS), prostate-specific antigen (PSA) and PSA density (PSAD) in the diagnosis of prostate cancer (CaP). Pati ents and methods Retrospective data were analysed from a selected popu lation of 159 patients (mean age 66.7 years, range 50-83), 56 with his tologically diagnosed CaP and 103 with benign prostatic hyperplasia (B PH). Results Among the four methods, DRE was found to have accuracy, s ensitivity and specificity rates of 79.9, 91 and 73.8% respectively Th e most common clinical practice, the combination of PSA (>4 ng/mL), DR E and TRUS, showed a higher accuracy, a similar specificity rate, but a lower sensitivity (84.2, 91.2 and 71.4%, respectively). Rates from t he combination of PSAD (>0.15 ng/mL/cm(3)) with DRE and TRUS were not significantly different from those obtained using the combination of P SA, DRE and TRUS. Conclusion PSAD alone or in combination did not impr ove the diagnostic Value of PSA. We cannot claim DRE was the best meth od for the diagnosis of CaP, because this study group did not represen t a true screening population. However, this study revealed that DRE s hould not be omitted from the physical examination of patients and, de spite technological developments, it remains a major tool in the diagn osis of CaP.