Vallancien G, Prapotnich D, Sibert L, Lugagne P M, Veillon B, Brisset J M, Andre-Bougaran J
Urology Department, Paris, France.
Eur Urol. 1989;16(5):321-4. doi: 10.1159/000471607.
167 patients with a mean age of 64 years underwent digital rectal examination (DRE), transrectal ultrasonography with a 7-MHz transverse and/or longitudinal transducer, followed by prostatic biopsy under ultrasound guidance. 231 biopsies were performed. 74 peripheral hypoechogenic zones were demonstrated. The sensitivity of DRE was 82% and the specificity 91%. The sensitivity and the specificity of ultrasound were respectively 69 and 83%. On 123 patients with normal DRE, 19 hypoechoic zones were detected and 2 patients had a positive biopsy (11%). On 104 patients without hypoechoic zone, 5 biopsies were positive (5%). The use of transrectal ultrasound scanning is able to multiply the number of impalpable cancer by 2, but in only 3 lobes, a hypoechogenic zone associated with a normal rectal examination was confirmed to be a cancer on biopsy. These cases represent 5.5 of the 56 positive biopsies, 4% of the hypoechogenic zones and 1.6% of the investigated patients with normal rectal examination. No impalpable cancer of 5 mm or less was detected by high resolution ultrasonography. DRE is still the most reliable examination for the diagnosis of prostatic cancer. Ultrasonography is a useful complement, particularly by allowing collection of tissue interpretable by the histologist in 100% of cases.
167名平均年龄为64岁的患者接受了直肠指检（DRE）、使用7兆赫横向和/或纵向探头的经直肠超声检查，随后在超声引导下进行前列腺活检。共进行了231次活检。发现74个外周低回声区。直肠指检的敏感性为82%，特异性为91%。超声的敏感性和特异性分别为69%和83%。在123名直肠指检正常的患者中，检测到19个低回声区，2名患者活检呈阳性（11%）。在104名无低回声区的患者中，5次活检呈阳性（5%）。经直肠超声扫描能够使触诊不到的癌症数量增加一倍，但只有3个叶中，与直肠检查正常相关的低回声区在活检时被证实为癌症。这些病例占56次阳性活检中的5.5例，占低回声区的4%，占直肠检查正常的被调查患者的1.6%。高分辨率超声未检测到5毫米或更小的触诊不到的癌症。直肠指检仍然是诊断前列腺癌最可靠的检查方法。超声检查是一种有用的补充，特别是在100%的病例中能让组织病理学家获取可解释的组织。
