Devonec M, Chapelon J Y, Cathignol D, Dubernard J M
J Urol (Paris). 1986;92(4):231-7.
The value of endorectal sonography for the diagnosis of prostatic cancer was established after retrospective interpretation of sonographic data issued from 213 patients without prior knowledge of either clinical or pathological data. Endorectal sonography was performed with a mechanical sectorial high frequency (7.5 MHz) probe realized by the authors. A pathology report (73 biopsies, 52 TUR, 7 suprapubic adenomectomy specimens) was available for 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 respectively 65% or 79% 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). Sensitivity for the diagnosis of cancer was only 48%: 53% 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 (29/42) is partly responsible for this lack of sensitivity. Sonography can reveal the presence of abnormalities in the echostructure of the gland but does not allow tissue characterization. Rectal examination and sonography are complementary techniques. In the same study, rectal examination had a 48% specificity and a 92% sensitivity.
在对213例患者的超声数据进行回顾性解读且事先不了解临床或病理数据的情况下，确定了直肠内超声对前列腺癌的诊断价值。直肠内超声检查采用作者自行研制的机械扇形高频（7.5MHz）探头进行。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）。根据所考虑的正常参考标准，即要么是病理检查正常的患者组（90例患者），要么是同一组加上直肠检查正常的另一组患者（171例患者），癌症诊断的特异性分别为65%或79%。癌症诊断的敏感性仅为48%：53%的癌症被错误地解读为前列腺炎或腺瘤，9%被解读为正常（2例T0和2例T1）。局部分期中无包膜侵犯的比例较大（29/42）是导致这种敏感性不足的部分原因。超声检查可显示腺体回声结构异常的存在，但无法进行组织特征描述。直肠指检和超声检查是互补技术。在同一研究中，直肠指检的特异性为48%，敏感性为92%。
