Grasso-Leanza F, Pepe P, Panella P, Pennisi M
Servizio di Urologia, Presidio Ospedaliero Cannizzaro, Ussl N. 36, Catania.
Arch Ital Urol Androl. 1995 Sep;67(4):237-41.
In the report we refer to our experience as regards the role of transrectal ultrasonography in the early diagnosis of prostatic heteroplasia based on the results obtained by a research led from January 1991 to January 1995 on 1185 dysuria patients who have been subjected also to a rectal exploration and a serous dosage of PSA. Among the 306/1185 (25.8%) of the patients subjected to prostatic echoguided biopsy sec. Hodge in 238 (77.7%) a hypoechogenic zone on behalf of the periphery of the prostatic parenchyma has been reported. The histological result has pointed out the presence of adenocarcinoma in 81 (26.4%) patients; of benign prostatic hypertrophy in 196 (64%); of acute and/or chronic non specific phlogosis in 26 patients (8.4%) and granulomatosis prostatitis in 3 (1%). The sensibility, the specificity and the diagnostic efficiency of the transrectal ultrasonography in the diagnosis of prostatic heteroplasia have resulted equal, respectively to 100%, to 30.2% and to 48.6%. In 122 patients (66%) the hypoechogenic zone was not pathognomonic of prostatic heteroplasia. Definitely, considering the high sensibility in opposition to the insufficient specificity of the echography, it is our future intention not submit to prostatic biopsy those patients who show only a hypoechogenic zone in absence of pathology EDR and PSA but to monitor them through quarterly clinic checks.
在本报告中，我们根据1991年1月至1995年1月对1185例排尿困难患者进行的一项研究结果，阐述了经直肠超声检查在前列腺发育异常早期诊断中的作用。这些患者还接受了直肠探查和血清前列腺特异性抗原（PSA）检测。在1185例接受前列腺超声引导下活检（按照霍奇方法）的患者中，有306例（25.8%），其中238例（77.7%）报告在前列腺实质周边存在低回声区。组织学结果显示，81例（26.4%）患者存在腺癌；196例（64%）患者为良性前列腺增生；26例（8.4%）患者为急性和/或慢性非特异性炎症，3例（1%）患者为肉芽肿性前列腺炎。经直肠超声检查在前列腺发育异常诊断中的敏感性、特异性和诊断效率分别为100%、30.2%和48.6%。在122例患者（66%）中，低回声区并非前列腺发育异常的特征性表现。当然，考虑到超声检查敏感性高但特异性不足，我们未来打算不对那些仅显示低回声区而无病理检查结果（EDR）和PSA异常的患者进行前列腺活检，而是通过每季度的临床检查对他们进行监测。
