Prostate cancer with normal serum PSA: a report of 6 cases and literature review
10.3969/j.issn.1009-8291.2023.02.011
- VernacularTitle:血清前列腺特异抗原正常的前列腺癌6例报告及文献复习
- Author:
Xiao YUE
1
;
Dongming WANG
1
;
Chuangui LI
1
;
Qiang WANG
1
;
Zhihua HUANG
2
;
Jing YAN
3
;
Qiuchen XU
3
Author Information
1. Department of Urology, Baoding First Central Hospital, Baoding 071000, China
2. Department of Emergency, Baoding First Central Hospital, Baoding 071000, China
3. Venous Dispensing Center, Baoding First Central Hospital, Baoding 071000, China
- Publication Type:Journal Article
- Keywords:
normal PSA level;
prostate cancer;
high-risk factors;
biopsy indication;
detection rate
- From:
Journal of Modern Urology
2023;28(2):133-136
- CountryChina
- Language:Chinese
-
Abstract:
【Objective】 To analyze the clinical data of prostate cancer patients with normal PSA level confirmed with transperineal prostate biopsy or transurethral prostate surgery, in order to improve the diagnostic level of this disease. 【Methods】 The clinical data of 6 patients were retrospectively analyzed. The age,clinical manifestations, body mass index (BMI),prostate specific antigen density (PSAD),blood triglycerides,blood cholesterol,color ultrasound imaging,magnetic resonance imaging (MRI),pathological types and Gleason scores were analyzed. The clinical characteristics and high-risk factors were summarized. 【Results】 Two cases were confirmed with prostate biopsy and four after prostate resection. Three patients had high blood triglycerides, three were negative for bone imaging, and the other three were not examined. PSAD was 0.017 to 1.215. Color ultrasound indicated that two cases had irregular morphology, two uneven echo, and one both irregular morphology and uneven echo; all six cases had calcification. In the three cases who received MRI, two had PIRADS4 nodules, one had PIRADS5 nodules, invasion of seminal vesicle, rectum, posterior wall of urinary bladder,bilateral thickening of NVB, and lymph nodes enlargement. Pathology suggested prostatic acinar adenocarcinoma in five cases, four of which had a Gleason score of 3+3=6 and one had 5+5=10; one case suggested a high-grade neuroendocrine carcinoma. 【Conclusion】 The clinical detection rate is low for prostate cancer with normal PSA. The biopsy indications should be determined by combining the characteristics and high-risk factors to improve the detection rate.
