前立腺特異抗原(PSA)軽度上昇症例におけるα1アドレナリン受容体遮断薬内服によるPSAの変化について: 前立腺肥大症/下部尿路症と前立腺癌の比較

Abstract

The aims of this study were to define the relationships between prostate-specific antigen (PSA) and alpha 1-adrenergic receptor antagonist (alpha 1 blocker). A prospective clinical study of 48 male patients examined between May 2004 and December 2007 was performed. 4.0-9.9 ng/ml PSA level who had no notable clinical findings of urinary retention, urinary tract infections and prostate cancer (PC) received tamusulosin 0.2 mgonce daily for 3 months, and then received prostate biopsy. We divided the patients into two groups : PC and benign prostate hyperplasia (BPH)/lower urinary tract symptom (LUTS) group. In total, the PSA level showed no significant change after treatment. In the PC group, PSA significantly increased after treatment. However, PSA decreased in the BPH/LUTS group. The alpha 1 blocker significantly improved urination status (the subjective symptoms and urodynamics parameters) in the BPH/LUTS group. In two groups, prostate volume showed no significant difference. Among those patients in the BPH/LUTS group, their urination status was significantly improved with alpha 1 blocker and their PSA level dropped slightly. On the other hand, the PSA level was significantly increased in the PC group. This study shows that by usingan alpha 1 blocker, it may be possible to avoid conductingthe prostate biopsy at an early stage or indeed one may not be needed at all for patients with only slight increases in PSA.