Toubert M E, Schlageter M H, Bron J, Teillac P, Le Duc A, Najean Y
Service de Médecine Nucléaire, Hôpital Saint-Louis, Paris.
Presse Med. 1990 Jun 16;19(24):1139-42.
Systematic screening for prostate cancer was carried out in 600 men over 50 years of age by the industrial medicine departments of four big companies in the Paris region. The exploratory methods included prostate specific antigen (PSA) and prostatic acid phosphatase (PAP) assays, rectal palpation and two-dimensional transrectal ultrasonography. Biopsy of the prostate was performed either when the PSA level was above 5 ng/ml or when rectal palpation gave suspicious results, or when ultrasonography showed abnormal images. A total of 93 biopsies were performed, and 18 cases of cancer were detected. Eleven of these 18 patients underwent radical prostatectomy. The PSA assay, with an accepted limit of 5 ng/ml, detected 17 out of 18 cancers but was not very specific. The PAP assay had low sensitivity (only 5 positive results). Combined PAP assay and rectal palpation provided high sensitivity and good specificity. Transrectal ultrasonography was helpful only to determine the site of biopsy and the distribution of the lesions.
巴黎地区四家大公司的工业医学部门对600名50岁以上男性进行了前列腺癌的系统筛查。探索性方法包括前列腺特异性抗原（PSA）和前列腺酸性磷酸酶（PAP）检测、直肠指诊和二维经直肠超声检查。当PSA水平高于5 ng/ml，或直肠指诊结果可疑，或超声检查显示异常图像时，进行前列腺活检。共进行了93次活检，检测出18例癌症。这18例患者中有11例接受了前列腺根治术。PSA检测的可接受上限为5 ng/ml，检测出了18例癌症中的17例，但特异性不强。PAP检测敏感性低（只有5个阳性结果）。PAP检测与直肠指诊相结合提供了高敏感性和良好的特异性。经直肠超声检查仅有助于确定活检部位和病变分布。
