Diagnostic value of serum prostate-specific antigen in hemodialysis patients.
BACKGROUND
The value of serum prostate-specific antigen (PSA) screening was examined to detect prostate cancer in men receiving hemodialysis.


METHODS
Forty-one male patients age 60-95 (median age, 70 years) receiving hemodialysis were investigated for PSA levels. We set the cut-off point at 4 ng/mL (the usual reference range). Digital rectal examination (DRE) and transrectal ultrasonography (TRUS) of the prostate were performed in patients whose PSA was more than 4 ng/mL and/or who expected further examination of the prostate. When prostate cancer was suspected, biopsy of the prostate was performed. In patients with prostate cancer, magnetic resonance imaging, computed tomography and bone scintigraphy were performed to diagnose the clinical stage.


RESULTS
The mean serum level of PSA was 2.10 +/- 0.49 ng/mL. In this screening study, four of 41 men required further examinations for prostate cancer. Two of four refused further examinations. The other two were diagnosed with prostate cancer. The incidence of prostate cancer was at least 5% in our hemodialysis patients. One man, whose clinical stage was T2aN0M0, was treated with radical retropubic prostatectomy. Another man, whose clinical stage was T2bN0M0, was treated with luteinizing hormone-releasing hormone analogue.


CONCLUSIONS
In our preliminary study, prostate cancer screening with PSA was useful for the early detection of prostate cancer in hemodialysis patients. If possible, DRE and TRUS should be performed in conjunction with PSA tests.
Sumura
Maahiro
M
Departments of Urology, Matsue Seikyou General Hospital, Shimane, Japan. m.sumura@oki-hospital.com
Yokogi
Hiroyuki
H
Beppu
Masako
M
Honda
Hiroshi
H
D000230:Adenocarcinoma / Q000097:blood / Q000175:diagnosis* / Q000628:therapy; D000368:Aged; D000369:Aged, 80 and over; D006801:Humans; D007676:Kidney Failure, Chronic / Q000628:therapy; D008297:Male; D008403:Mass Screening / Q000379:methods; D008875:Middle Aged; D010173:Palpation / Q000379:methods; D017430:Prostate-Specific Antigen / Q000097:blood*; D011471:Prostatic Neoplasms / Q000097:blood / Q000175:diagnosis* / Q000628:therapy; D012007:Rectum / Q000000981:diagnostic imaging; D006435:Renal Dialysis; D014463:Ultrasonography
D017430:Prostate-Specific Antigen