Guinan P, Ray P, Bhatti R, Rubenstein M
Division of Urology, University of Illinois, Chicago 60612.
Prog Clin Biol Res. 1987;243A:551-8.
In an effort to determine which of five tests was the most efficient in the diagnosis of prostate cancer, 280 male patients were screened employing aspiration cytology, transrectal ultrasound, acid phosphatase, prostate specific antigen, and the digital rectal examination. The digital rectal examination was the most efficient (75%) and in order of decreasing accuracy were prostate specific antigen (74%), prostatic ultrasound (71%), acid phosphatase (66%), and finally aspiration cytology (63%). In an era when what are more expensive and more technology are assumed to be better, what is simple and traditional is ignored. From an evaluation of these patients it appears that the digital rectal examination still retains its diagnostic efficiency. Finally, in this age of escalating medical costs and physician accountability for these expenses, you can't beat the cost - benefit ratio for the old fashioned rectal exam.
为了确定五项检查中哪一项在前列腺癌诊断方面效率最高，对280名男性患者采用抽吸细胞学检查、经直肠超声检查、酸性磷酸酶检查、前列腺特异性抗原检查以及直肠指检进行了筛查。直肠指检效率最高（75%），按准确性递减顺序依次为前列腺特异性抗原（74%）、前列腺超声检查（71%）、酸性磷酸酶检查（66%），最后是抽吸细胞学检查（63%）。在一个认为更昂贵、技术更先进就更好的时代，简单和传统的方法被忽视了。从对这些患者的评估来看，直肠指检似乎仍保持其诊断效率。最后，在这个医疗成本不断攀升且医生需对这些费用负责的时代，老式直肠指检的成本效益比无可匹敌。
