Bichat Claude Bernard Hospital, Public Assistance of Paris Hospitals, Paris, France.
National Veterinary School of Alfort, Nosaïs team, Maisons-Alfort, France.
World J Urol. 2024 Aug 25;42(1):497. doi: 10.1007/s00345-024-05201-z.
Prostate cancer diagnosis is confirmed with a prostate biopsy, which is invasive and unpleasant. Adding canine olfaction into the diagnostic protocol could help avoid unnecessary biopsies. This study aims to determine whether dogs can identify ISUP (International Society of Urological Pathology) > 2 prostate cancer.
This double-blind, prospective, validation study included men with suspected prostate cancer between November 2022 and April 2023 in France. They were classified into two groups according to their prostate biopsy results; cases (ISUP > 2) and controls (ISUP < 1 or negative). Seven dogs analyzed their urine. Sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) for canine olfactory detection of ISUP ≥ 2 prostate cancer were measured and compared with that of prostate MRI versus prostate biopsy.
The seven dogs analyzed 151 urine samples, 78 from the case group and 73 from the control group. The minimal and maximal observed values were 54% and 86% for sensitivity, and 69% and 88% for specificity. Five dogs had a sensitivity above 73% and six dogs had a specificity above 75%. The kappa coefficient quantifying agreement between the biopsy result and the MRI PI-RADS ≥ 3 was 0.17 [- 0.14; 0.17], 0.20 [0.02-0.33] for PI-RADS ≥ 4 and 0.64 [0.5-0.75] for canine olfaction meaning there is a substantial agreement between the biopsy result and canine olfaction.
Based on this study, the non-invasive and safe canine olfaction technique seems reliable for diagnosing ISUP ≥ 2 prostate cancer. Combined with prostate MRI, it may improve the decision-making process when choosing to perform prostate biopsies.
前列腺癌的诊断通过前列腺活检来确认，这种方法具有侵入性且令人不适。将犬类嗅觉纳入诊断方案可能有助于避免不必要的活检。本研究旨在确定狗是否能识别国际泌尿病理学会（International Society of Urological Pathology）分级大于 2 级（ISUP > 2）的前列腺癌。
这项双盲、前瞻性验证研究于 2022 年 11 月至 2023 年 4 月在法国进行，纳入疑似患有前列腺癌的男性。根据前列腺活检结果将他们分为两组：病例组（ISUP > 2）和对照组（ISUP < 1 或阴性）。7 只狗分析了他们的尿液。测量并比较了犬类嗅觉对 ISUP ≥ 2 级前列腺癌的检测的敏感性、特异性、阳性预测值（PPV）和阴性预测值（NPV），以及前列腺 MRI 与前列腺活检的检测结果。
这 7 只狗分析了 151 份尿液样本，其中 78 份来自病例组，73 份来自对照组。敏感性的最小和最大观测值分别为 54%和 86%，特异性的最小和最大观测值分别为 69%和 88%。5 只狗的敏感性超过 73%，6 只狗的特异性超过 75%。活检结果与 MRI PI-RADS ≥ 3 的一致性的 Kappa 系数为 0.17 [-0.14; 0.17]，PI-RADS ≥ 4 的一致性的 Kappa 系数为 0.20 [0.02-0.33]，而犬类嗅觉的一致性的 Kappa 系数为 0.64 [0.5-0.75]，这表明活检结果与犬类嗅觉之间存在显著一致性。
基于这项研究，非侵入性且安全的犬类嗅觉技术似乎可用于可靠地诊断 ISUP ≥ 2 级前列腺癌。与前列腺 MRI 相结合，可能会改善选择进行前列腺活检时的决策过程。
