Devonec M, Chapelon J Y, Cathignol D
Department of Urology, Antiquaille Hospital, INSERM Research Unit U80, Claude Bernard University, Lyon, France.
Eur Urol. 1988;14(3):189-95. doi: 10.1159/000472935.
The value of endorectal sonography for the diagnosis of prostatic cancer was established after retrospective interpretation of sonographic findings in 213 patients, without prior knowledge of either the clinical or pathological data. Endorectal sonography was performed by the authors with a mechanical sectorial high frequency (7.5 MHz) probe. A pathology report (73 biopsies, 52 TUR, 7 suprapubic adenomectomy specimens) was available from 132 patients: 25 pathological examinations were interpreted as normal; 41 adenomas; 24 prostatitis or fibrosis, and 42 cancers (5 clinical stage T0, 22 T1, 2 T2 and 13 T3). Specificity for the diagnosis of cancer was 65 or 81%, respectively, according to the normality reference considered, i.e. either the group of patients having a normal pathological control (90 patients) or the same group plus another group of patients with a normal rectal examination (171 patients). The sensitivity for the diagnosis of cancer was only 48%. 43% of cancers were falsely interpreted as prostatitis or adenomas and 9% as normal (2 T0 and 2 T1). The large proportion of local stages without capsular involvement (29 of 42) is partly responsible for this lack of sensitivity. Rectal examination and sonography are complementary techniques. In the same study, rectal examination had a 48% specificity and a 92% sensitivity.
在对213例患者的超声检查结果进行回顾性解读时，在事先不了解临床或病理数据的情况下，确定了直肠内超声检查对前列腺癌的诊断价值。作者使用机械扇形高频（7.5MHz）探头进行直肠内超声检查。132例患者有病理报告（73例活检、52例经尿道前列腺切除术、7例耻骨上腺瘤切除标本）：25例病理检查结果为正常；41例为腺瘤；24例为前列腺炎或纤维化，42例为癌症（5例临床分期为T0、22例为T1、2例为T2、13例为T3）。根据所考虑的正常标准，即病理对照正常的患者组（90例患者）或该组加上直肠指检正常的另一组患者（171例患者），癌症诊断的特异性分别为65%或81%。癌症诊断的敏感性仅为48%。43%的癌症被误诊为前列腺炎或腺瘤，9%被误诊为正常（2例T0和2例T1）。局部分期中无包膜侵犯的比例较大（42例中有29例）是导致这种敏感性不足的部分原因。直肠指检和超声检查是互补技术。在同一项研究中，直肠指检的特异性为48%，敏感性为92%。
