Hansen M V, Grönberg A
Department of Urology, Halmstad Hospital, Sweden.
Eur Urol. 1995;28(3):189-95. doi: 10.1159/000475050.
The diagnostic work-ups of 656 European urologists on theoretical cases of suspected early prostatic carcinoma were surveyed. The diagnostic work-ups varied considerably among the urologists. There was strong agreement that digital rectal examination (DRE) and prostate-specific antigen (PSA) should be used routinely in these cases, but there was a lack of agreement concerning the use of transrectal ultrasound examination (TRUS), prostate biopsies and bone scan. However, the use of TRUS, bone scan and biopsies was correlated positively to the PSA level and negatively to age (p < 0.0001), but was not correlated to whether the patient was asymptomatic or suffered from prostatism. Ninety-two percent of the urologists would perform biopsies if a palpable lesion were present. If the PSA was elevated, 22% would use biopsies if it was 7 ng/l, 62% if it was 15 ng/l and 83% if it was 35 ng/l. These results indicate that a majority of European urologists would attempt to diagnose prostatic cancer with biopsies only when results of DRE and PSA predict a high risk that the cancer is no longer organ-confined.
对656名欧洲泌尿外科医生针对疑似早期前列腺癌的理论病例的诊断检查情况进行了调查。泌尿外科医生之间的诊断检查差异很大。大家强烈认同在这些病例中应常规使用直肠指检（DRE）和前列腺特异性抗原（PSA），但对于经直肠超声检查（TRUS）、前列腺活检和骨扫描的使用缺乏共识。然而，TRUS、骨扫描和活检的使用与PSA水平呈正相关，与年龄呈负相关（p < 0.0001），但与患者是否无症状或患有前列腺增生无关。如果可触及病变，92%的泌尿外科医生会进行活检。如果PSA升高，当PSA为7 ng/l时，22%的医生会进行活检；当PSA为15 ng/l时，62%的医生会进行活检；当PSA为35 ng/l时，83%的医生会进行活检。这些结果表明，只有当DRE和PSA结果预测癌症不再局限于器官的风险很高时，大多数欧洲泌尿外科医生才会尝试通过活检来诊断前列腺癌。
