常规体检中进行前列腺癌筛查的临床意义

目的探讨前列腺癌患者就诊原因对于肿瘤特征和治疗的影响，评价常规体检中进行前列腺癌筛查的意义。方法回顾性分析1995-2008年北京医院泌尿外科诊断的前列腺癌患者病例资料，分析就诊原因与肿瘤相关特征的关系。结果前列腺癌患者432例，其中因下尿路症状就诊的有43．5％（188／432），43．1％（186／432）因体检异常就诊，13．4％（58／432）因其他原因发现前列腺癌。2005-2008年问54．2％（115／212）的患者是由于体检异常得到诊断，较往年增加；33．5％（69／212）的患者是下尿路症状就诊而得到诊断，较往年下降。因体检异常而发现的前列腺癌患者中早期前列腺癌的比例更高，采用根治性手术治疗的可能性更大。结论在老年男性体检中进行以前列腺特异抗原和直肠指诊为主的筛查有助于早期发现前列腺癌，提高根治性治疗的可能。

Prostate cancer screening in routine health examination

Objective To analyze the impact of clinical visit reason on characteristics and treatment of prostate cancer, and to access the effects of prostate cancer screening on routine health examination. Methods A retrospective analyses was made in prostate cancer patients who were diagnosed in Bcijing Hospital between 1995 and 2008. The correlation was compared between cancer characteristic and the reason why patient seek the treatment. Results Of 432 patients, 188 （43.5%） visited for lower urinary tract symptoms （ LUTS）, 186 （ 43. 1% ） for abnormal health check-up results, and 58 （ 13. 4% ） for other reasons. Between 2005 and 2008, 54. 2% prostate cancer was found in health examination. The early detection rate was higher in the health examination group and was more possibly treated by radical prostatectomy. Conclusion Digital rectal examination and serum prostate specific antigen test in routine health examination may help early detection of prostate cancer and make an opportunity of radical treatment.