Osegbe D N, Magoha G
Postgrad Med J. 1982 Dec;58(686):763-6. doi: 10.1136/pgmj.58.686.763.
Serum acid phosphatase was measured in patients with enlarged benign and malignant prostate before and after rectal examination. Amongst the patients with benign glands, rectal examination did not produce any significant false elevation of the enzyme. Rectal examination, however, caused a rise in the enzyme level in a few untreated cancer patients and in cancer patients who had become refractory to hormonal therapy. This rise would help rather than mislead in the diagnosis of malignant prostate and also in identifying treated patients who had become refractory to treatment. Thus, when serum acid phosphatase is properly determined, elevated levels should always arouse suspicion of malignant prostate or other lesions associated with high enzyme level even if such determination was preceded by rectal examination. There appears to be no merit in the teaching that the determination of serum acid phosphatase should be delayed after rectal examination.
在直肠指检前后，对良性前列腺肿大和恶性前列腺肿大患者测定了血清酸性磷酸酶。在良性腺体患者中，直肠指检未导致该酶出现任何显著的假性升高。然而，直肠指检使一些未经治疗的癌症患者以及对激素治疗产生耐药性的癌症患者的酶水平升高。这种升高有助于而不是误导前列腺癌的诊断，也有助于识别对治疗产生耐药性的已治疗患者。因此，当血清酸性磷酸酶测定得当，即使在直肠指检之后进行该测定，酶水平升高也应始终引起对前列腺癌或其他与高酶水平相关病变的怀疑。有一种观点认为直肠指检后应推迟血清酸性磷酸酶的测定，这种观点似乎没有道理。
