Objective To assess the detection of prostate cancer A TRUS abnormality was detected in 54 of 204 (26%) patients, of whom 25 (46%) had positive biopsies. Of using the Ciba Corning ACS 180 prostate-specific antigen (PSA) assay and transrectal ultrasonography these 54, there were 43 with hypoechoic lesions, of whom 22 (51%) had positive biopsies. The cancer (TRUS) in a district general hospital. Patients and methods In a preliminary study, the serum detection rate was higher when both TRUS and DRE were positive (62%), with the highest detection rate PSA level in 130 patients was measured using both the Ciba Corning and the Hybritech Tandem-R PSA (86%) occurring when the PSA level was also >30.0 ng/mL. When the DRE was positive, cancer assay and the results assessed using linear regression analysis. A further study comprised 204 consecutive was detected in 21 of 34 (62%) patients with a positive TRUS, but only in 17 of 59 (29%) patients with a patients who underwent TRUS and biopsy. The histology of the prostatic biopsies was analysed according negative TRUS (P<0.005). However, when the DRE was negative there was no significant difference in the to the pre-biopsy PSA level (Ciba Corning assay), digital rectal examination (DRE) and TRUS findings.cancer detection rates for TRUS-positive and TRUSnegative patients, where four of 20 and 14 of 91 (15%) Results The PSA levels measured using the Ciba Corning assay were about 50% higher than those using the patients were found to have cancer, respectively. Conclusions The positive biopsy rates in this study were Hybritech Tandem-R assay. Of 204 men who had TRUS and biopsy, 56 (28%) had detectable prostate comparable with those from similar studies using other PSA assays. When the DRE was negative there was a cancer, but no patient with a PSA of <6.0 ng/mL had. Five of 47 (11%), 21 of 83 (25%) and 30 of 65 (46%) low detection rate for cancer of 3% for men with PSA levels of 6.1-15.0 ng/mL. In patients with an elevated patients with PSA levels in the range 6.1-15, 15.1-30 and >30 ng/mL, respectively, had cancer detected.PSA level but a negative DRE, the positive biopsy rate for TRUS-negative patients did not differ from TRUSWhen the DRE was negative, 18 of 111 (16%) patients had a positive biopsy, compared with 38 of 93 (41%) positive patients, indicating the importance of random systematic biopsies. patients when the DRE was positive (P<0.001). In men with a PSA level of 6.1-15.0 ng/mL, positive Keywords Ciba Corning ACS 180 assay, prostate-specific antigen, digital rectal examination, transrectal biopsies were found in 3% when the DRE was negative, compared with 27% when it was positive (P<0.025).ultrasonography, prostate cancer, positive biopsyThe predictive capacity of DRE, PSA and TRUS, indi-
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