title: [The early diagnosis of prostate cancer in a selected population. The usefulness of PSAD, PSAD ad. and age-adjusted PSA in patients with a PSA between 4-10 ngr./ml].
abstract: BACKGROUND
  Exposition of our experience in the early diagnosis of prostate cancer, based on the initial selection of patients.
  
  
  METHODS
  Evaluation of patients from within the area covered by our hospital and seen for signs and symptoms of prostatism. Those with suspicion rectal examination (RE) or PSA greater than 4 ng/ml were further evaluated with transrectal ultrasound and prostate biopsy.
  
  
  RESULTS
  Based on the biopsies of 700 patients, prostate carcinoma was diagnosed in 294/700 (42%). 55.72% patients with suspicion RE, and 47.5% with PSA > 4 had cancer. In patients with PSA > 4 and non-suspicion RE, cancer was detected in 16.44%. The percentage of neoplasia in patients with PSA 4-10 ng/ml and non-suspicion RE was 10%. As a result of these findings, 88 radical prostatectomies were performed. PASD and PASD ad. showed significant differences between patients with and without cancer, whether with (+)RE (p = 0.0001) or (-)RE (p < 0.0004), unlike PSA that showed no differences. The diagnostic value shown by PSAD ad. in ROC curves was similar to that of PSAD. Value of age-adjusted PSA was not higher than PSAD.
  
  
  CONCLUSIONS
  Performance of prostate biopsy with a suspicion RE is recommended. If RE shows no suspicion, biopsy should be performed when PSA is > 10 ng/ml, and with PSA 4-10 ng/ml a biopsy is advocated with PSAD > 0.15.
authors.affiliation: Servicio de Urología, Hospital Miguel Servet, Zaragoza.
authors.forename: C A
authors.initials: CA
authors.lastname: Allepuz Losa
authors.forename: M J
authors.initials: MJ
authors.lastname: Gil Sanz
authors.forename: A
authors.initials: A
authors.lastname: Gonzalvo Ibarra
authors.forename: M
authors.initials: M
authors.lastname: Blas Marín
authors.forename: J I
authors.initials: JI
authors.lastname: Sanz Velez
authors.forename: L A
authors.initials: LA
authors.lastname: Rioja Sanz
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000375:Aging / Q000097:blood* / Q000473:pathology; D001707:Biopsy, Needle; D002277:Carcinoma / Q000097:blood / Q000175:diagnosis* / Q000473:pathology; D006801:Humans; D008297:Male; D008875:Middle Aged; D018579:Patient Selection; D011467:Prostate / Q000000981:diagnostic imaging / Q000473:pathology; D017430:Prostate-Specific Antigen / Q000097:blood*; D011471:Prostatic Neoplasms / Q000097:blood / Q000175:diagnosis* / Q000473:pathology; D013997:Time Factors; D014463:Ultrasonography
chemical_list: D017430:Prostate-Specific Antigen