Connolly J A, Shinohara K, Presti J C, Carroll P R
Department of Urology, University of California School of Medicine, San Francisco, CA 94143-0738, USA.
Urology. 1996 Feb;47(2):225-31. doi: 10.1016/S0090-4295(99)80421-X.
To define the sonographic characteristics of local cancer recurrence after radical prostatectomy.
in 114 patients with an elevated prostate-specific antigen (PSA) and negative bone scan, 156 ultrasound-guided prostate fossa biopsies were carried out.
in 53.5%, biopsy proved local recurrence. More than one ultrasound-guided biopsy session was required to make the diagnosis in 33% of patients. Local recurrence was seen on ultrasound at the anastomotic site (66%), the bladder neck (16%), and posterior to the trigone (13%). in 5% of patients there was a normal-appearing anastomotic site. Transrectal ultrasound was greater than 90% sensitive in detecting local recurrence, but lacked specificity. Examination of the radical prostatectomy specimens in patients with local recurrence showed positive surgical margins in 66% and organ-confined disease in 20%.
Transrectal ultrasonography is a useful adjunct to PSA and digital rectal examination in the detection of local recurrences following radical prostatectomy.
明确根治性前列腺切除术后局部癌症复发的超声特征。
对114例前列腺特异性抗原（PSA）升高且骨扫描阴性的患者进行了156次超声引导下前列腺窝活检。
53.5%的患者活检证实为局部复发。33%的患者需要进行不止一次超声引导下活检才能确诊。超声检查发现局部复发位于吻合口部位（66%）、膀胱颈（16%）和三角区后方（13%）。5%的患者吻合口部位外观正常。经直肠超声检测局部复发的敏感性大于90%，但缺乏特异性。对局部复发患者的根治性前列腺切除标本检查显示，66%的患者手术切缘阳性，20%的患者为器官局限性疾病。
经直肠超声检查在根治性前列腺切除术后局部复发的检测中是PSA和直肠指检的有用辅助手段。
