前立腺癌治療の現況と問題点 - 前立腺癌早期発見の努カ -

Abstract

1983年までの8年間は, 1次検診は経直腸的超音波断層法のみで行い, 1984年以後は検査法の診断能力を検討するため触診を, また1987年の検診には腫瘍マーカーを1次検診に加えた.1次検診受診者は6, 674人, 平均年齢65.5歳.2次検診必要者は1, 811人で, このうち前立腺癌の疑いは675人(受診者の10.1%)であった.2次検診の結果, 前立腺癌42人(受診者の0.6%), 肥大症1, 396人(受診者の20.9%)が検出された.癌患者の年齢分布は56歳～87歳(平均72.2歳)であった.検出された前立腺癌の病期はstage A 1例, stage B 23例, stage C 11例, stage D 7例であった.前立腺癌42症例の累積生存率をみると, 5年生存25例であった

Since 1975 up to 1988, we have performed a mass screening program (MS) for prostatic diseases using transrectal ultrasonography (TRS) in the primary study. In our study, 42 cases of prostatic cancer (0.6%) was detected among 6, 674 examinees. Out of 42 cases of cancer, 24 (57.1%) were diagnosed as early prostatic cancer (Stage A 1, Stage B 23). The detection rate of cancer in MS and the ratio of early stage of cancer among them were higher than those in the outpatient clinic of our department. Diagnostic accuracy of TRS, palpation and tumor markers in MS were studied respectively through our series of MS. TRS was useful for MS especially in low false negative rate. On the other hand, palpation was characteristic in low false positive rate. Prostatic specific antigen (PSA) among tumor markers was effective to detect early prostatic cancer. However, there were some problems about distinguishing early prostatic cancer from BPH, because of the high false positive rate.