COMPREHENSIVE DIAGNOSIS OF PROSTATE CANCER

Abstract

Aim. The purpose of the study is to study the possibility of clinical, laboratory and instrumental diagnostics in the combination in the diagnosis of prostate cancer. Material and methods. 147 patients were examined, the middle age of which was 69.5 ± 6.7 years. All patients underwent examination: identification of the level of prostate-specific antigen (PSA) in blood serum, ultrasound transabdominal and transrectal examination in B mode, followed by the use of color Doppler mapping of blood flow, 3-dimensional Dopplerography, elastography and intravenous contrast enhancement. All patients underwent multifocal transrectal biopsy under ultrasound control followed by morphological examination of the obtained material. Results and discussion. The digital rectal examination found an increase of the prostate’s size at 115 patients, increase of the prostate’s density – at 69 patient, the high density’s existence of separate nodes - at 59 patients. The median level of prostate-specific antigen in the blood serum of the surveyed patients was 16,5±6,7 ng / ml. Under transrectal ultrasound at 88 patients the hypoechogenicity center, at 34 – isoechogenicity and at the 22 th center – the mixed echogenic was revealed. We identified 111 patients with abnormal vascularity in disintegration and deformation of vascular pattern. Hyperintensive contrast in 59.0% of cases, rapid accumulation of the contrast agent in 56.0% and rapid leaching of the drug in 59.0% of cases were characteristic of prostate cancer. Comparison of data obtained at transrectal ultrasound with indicators of the Gleeson’s scale was carried out. It was established that hypoechogenic focus is more common in the total score 5-7, and less than 5 points, isoechogenic tumor often with a score 5-7. The pathological vascularization was more often diagnosed in the group of patients with a score 5-7. Conclusion. The use of clinical laboratory and modern methods of ultrasound examination in a complex allows to increase the effectiveness of prostate cancer diagnosis, which undoubtedly contributes to the choice of rational treatment tactics.