Fiorelli R L, Klaus R L, Manfrey S J, Belkoff L H, Finkelstein L H
Department of Urology, Osteopathic Medical Center of Philadelphia, PA.
J Am Osteopath Assoc. 1991 Sep;91(9):863-70.
We prospectively studied 103 men who had normal results on digital prostate examinations but had bladder outlet obstruction secondary to prostatic hypertrophy and needed transurethral prostatectomy. All men underwent a preoperative transrectal ultrasonographic examination of the prostate and prostate-specific antigen (PSA) level determination. A total of 30 cancers were ultimately detected, 22 (73%) of which were detected preoperatively by either an abnormal ultrasonogram or elevated PSA levels (or both). Eight of these men were spared transurethral prostatectomy and had definitive treatment based on transrectal biopsy and appropriate staging evaluation. For PSA and ultrasonography combined, the sensitivities and negative predictive values for cancer (92% and 94%, respectively) were superior to the specificities and positive predictive values (71% and 64%, respectively). The combined use of both studies is recommended to rule out cancer in candidates for prostatectomy but not to routinely screen the general male population older than 40 years.
我们前瞻性地研究了103名男性，他们的直肠指检结果正常，但因前列腺增生继发膀胱出口梗阻，需要行经尿道前列腺切除术。所有男性均接受了术前经直肠超声检查前列腺及测定前列腺特异性抗原（PSA）水平。最终共检测出30例癌症，其中22例（73%）术前通过超声检查异常或PSA水平升高（或两者兼有）被检测出来。其中8名男性免于行经尿道前列腺切除术，并根据经直肠活检和适当的分期评估接受了确定性治疗。对于PSA和超声检查联合应用，癌症的敏感性和阴性预测值（分别为92%和94%）优于特异性和阳性预测值（分别为71%和64%）。建议联合使用这两项检查以排除前列腺切除术候选者中的癌症，但不建议对40岁以上的一般男性人群进行常规筛查。
