마스크모 목적으로 finasteride 복용 중 PSA 도 걱정되는 수치, 중지한 상태에서 대박이네

60대 중반 혈압 약, 고지혈증 약물 투여 중에 20하나 9년의 봄 초진 전립선 비대의 증상으로 혈압 약과 다른 타원에서 finastride등 3가지 약 복용 중이었다는 사실 그래도 증상이 불편하다는 호소한 경우에 다른 약은 중지하고 tamsulosin만 처방하고 한달 이하, 7월 IPSS 28->tamsulosin의 증량 2개월 이하, 9월"이전 약제보다는 증상은 좋지만...", IPSS 33?"지난해에 전립샘 부피는 30정도.'잔뇨는 없고...' 중간에 눈과 손 부종으로 tamsulosin을 감량했다.증량했다 조절하다​ 하나 2월 IPSS하나 3초음파 평가하기로 계획한 것 ​ 하나 월"소변은 밤에 한번 정도 보고 있다. 속이 거북하다."이전 답십리 대형 검진 내과에서 시행한 PSA확인 20하나 9년 한개 달 PSA 2.87(finastride의 억제 효과가 없다면 5.74에 해당한다.)"finastride 먹고부터 6~7년 이과의 요즘 7~8개월 복용하지 않았다."​ 초음파 견해상 전립샘 부피는 60 ml이상

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finastride자신 dutastride들의 약은 psa~50%억제합니다.지난해 1월의 대형 검진 내과에서 시행한 수치도 투약하는 약재를 고려합니다라면 사고가 있는 있다. (>4.0에 해당하는)최근 투약하지 않음을 확인하고 재확인한 PSA는 9.05였다. 비뇨기과 조직검사 등 상의 예정 PSA에 대한 복잡한 배경사실 Test performance — Determining the accuracy of PSA testing has beendifficult becausemost men with normal PSA values will not undergobiopsy unless their DREis abnormal PSA values will normalues works works bis workergostess undergostess undergSA is that the transrectal needle biopsy is not a perfect gold standard.Investigators have suggested that the false-negative rate can range from 10 to 20 percent, though the trend towards obtaining 12 samples has increased the detection rate.Additionally, protocols that use large numbers of biopsies to evaluate patients with an elevated PSA may be detecting incidental cancers that were not the etiology of the PSA elevation.One review that assumed that nonpalpable cancers smaller than 1.0 cm3 would not cause elevated PSA levels estimated that approximately 25 percent of cancers detected by PSA screening were too small to have accounted for the PSA rise that prompted a biopsy.The diagnostic performance of PSA ideally needs to be calibrated against clinically important cancers.However, there is no consensus on defining such cancers.Although many experts consider tumors with Gleason scores≥ 7 and volumes>0.5 cm3 to have a greater risk for progression, there is no certainty that these cancers will lead to early death or reduce quality of life.Sensitivity and specificity— The traditional cutoff for an abnormal PSA level in the major screening studies has been 4.0 ng/mL.The오메리카 n Cancer Society(ACS)systematically reviewed the literature assessing PSA performance.In a pooled analysis, the estimated sensitivity of a PSA cutoff of 4.0 ng/mL was 21 percent for detecting any prostate cancer and 51 percent for detecting high-grade cancers(Gleason≥ 8). Using a cutoff of 3.0 ng/mL increased these sensitivities to 32 and 68 percent, respectively.The estimated specificity was 91 percent for a PSA cutoff of 4.0 ng/mL and 85 percent for a 3.0 ng/mL cutoff.PSA has poorer discriminating ability in men with symptomatic BPH.Positive predictive value— The test performance statistic that has been best characterized by screening studies is the positive predictive value:the proportion of men with an elevated PSA who have prostate cancer.Overall, the positive predictive value for a PSA level>4.0 ng/mL is approximately 30 percent, meaning that slightly less than one in three men with an elevated PSA will have prostate cancer detected on biopsy.For PSA levels between 4.0 to 10.0 ng/mL, the positive predictive value is approximately 25 percent;this increases to 42 to 64 percent for PSA levels>10 ng/mL.However, nearly 75 percent of cancers detected within this"gray zone"of PSA values between 4.0 to 10.0 ng/mL are organ-confined and potentially curable.The proportion of organ-confined cancers is lower, less than 50 percent, for PSA values above 10.0 ng/mL.Negative predictive value— The Prostate Cancer Prevention Trial, which biopsied men with normal PSA levels, estimated a negative predictive value of 85 percent for a PSA value≤ 4. 0 ng/mL. ​ ​ ​ ​ 동대문구 답십리 우리 가운데 유아, 우리 중 사랑 내과, 건강 검진 클리닉 내과 전문의 정 뵤은용 www.loveinwoori.com

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