下部尿路症状を主訴とする受診症例における前立腺癌発見率

The detection rate of prostate cancer in outpatients presenting lower urinary tract symptoms

下部尿路症状を主訴に泌尿器科外来を受診した50歳から79歳の男性504例における前立腺癌の発見率を調査した。血清前立腺特異抗原値が4.1ng/ml以上，または，直腸診や経直腸的前立腺超音波断層法にて異常所見を認めた128例に対し前立腺生検を勧めた。128例中74例（57.8％）に前立腺生検を施行し，22例（4.4％）の前立腺癌を発見した。下部尿路症状を主訴とする症例における前立腺癌発見率は，前立腺集団検診・ドック検診のそれより高率であった。したがって，下部尿路症状を主訴に外来を受診した50歳以上の症例に対しては前立腺癌精査が必要と考えられた。なお，本検討においては前立腺癌症例に特徴的な下部尿路症状は認められなかった。

We evaluated the detection rate of prostate cancer in male outpatients presenting lower urinary tract symptoms（LUTS）. Between 1995 and 2001,504male outpatients from 50 to 79 years old who visited our clinic presenting LUTS were evaluated. All of them received serum prostate specific antigen（PSA）determination and digital rectal examination（DRE）. LUTS was evaluated by the International Prostate Symptom Score（IPSS）. We recommended transrectal prostate biopsy to 128 patients who had either a PSA level of 4.1ng/ml or higher,or abnormal findings on DRE or transrectal ultrasonography. Of the 128 patients,74（57.8％）underwent prostate biopsy and we detected prostate cancer in 22（4.4％）. Thus,the detection rate of prostate cancer was 4.4％ in patients with LUTS,which was significantly higher than that detected in mass screening. This result suggests that close examinations for prostate cancer in cluding PSA and DRE are recommended in patients aged 50 years or older who present with LUTS. No LUTS specific to prostate cancer were identified in the study.