[超声引导下经直肠前列腺穿刺活检在前列腺癌诊断中的阳性率]
[Yield of ultrasonography-guided transrectal biopsy in the diagnosis of carcinoma of the prostate].
作者信息
Fernández González I, Ruiz Rubio J L, Llorente Abarca C, Aramburu González J A, Montes Díaz M J, Herrero Payo A, Sánchez Sánchez E, Berenguer Sánchez A
机构信息
Servicio de Anatomía Patológica, Hospital Universitario de Getafe, Madrid, España.
出版信息
Arch Esp Urol. 1995 Jul-Aug;48(6):587-94.
OBJECTIVES
The present study analyzes the combination of digital rectal examination (DRE), prostate specific antigen (PSA), transrectal ultrasound (TRUS) and ultrasound-guided transrectal biopsy in the diagnosis of prostate cancer.
METHODS
115 of 224 patients (51.3%) were biopsied due to a suspicious DRE and/or PSA > 4 ng/ml, and/or DPSA > 0.15, and/or the presence of a hypoechoic lesion on TRUS.
RESULTS
Adenocarcinoma of the prostate was diagnosed in 28 (24.3%) of these 115 patients. The positive predictive value (PPV) for carcinoma of the prostate was 4.76% if PSA was < 4 ng/ml, 5.12% if PSA was 4.1 to 10 ng/ml, and 48% if PSA was > 10 ng/ml. If DPSA is considered, the PPV is 7.4% if PSA is 4.1 to 10 ng/ml and 51.02% if PSA is > 10 ng/ml. If DRE is suspicious, the PPV is 43.6%, with a sensitivity of 85.7% and a specificity of 63.9%. The PPV for carcinoma of the prostate was 34% for a hypoechoic lesion on TRUS, 50% if DRE is suspicious, 53.5% is PSA is > 10 ng/ml and 65% if DRE is suspicious and PSA > 10 ng/ml.
CONCLUSIONS
The detection rate of carcinoma of the prostate is increased when DRE, PSA, TRUS and US-guided transrectal biopsy are used in combination.
目的
本研究分析直肠指检（DRE）、前列腺特异性抗原（PSA）、经直肠超声（TRUS）及超声引导下经直肠活检联合应用在前列腺癌诊断中的价值。
方法
224例患者中，115例（51.3%）因DRE可疑和/或PSA>4 ng/ml，和/或游离PSA（DPSA）>0.15，和/或TRUS发现低回声病变而行活检。
结果
这115例患者中28例（24.3%）诊断为前列腺腺癌。PSA<4 ng/ml时前列腺癌的阳性预测值（PPV）为4.76%，PSA为4.1至10 ng/ml时为5.12%，PSA>10 ng/ml时为48%。若考虑DPSA，PSA为4.1至10 ng/ml时PPV为7.4%，PSA>10 ng/ml时为51.02%。若DRE可疑，PPV为43.6%，敏感性为85.7%，特异性为63.9%。TRUS发现低回声病变时前列腺癌的PPV为34%，DRE可疑时为50%，PSA>10 ng/ml时为53.5%，DRE可疑且PSA>10 ng/ml时为65%。
结论
联合应用DRE、PSA、TRUS及超声引导下经直肠活检可提高前列腺癌的检出率。
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