Herranz Amo F, Díez Cordero J M, Verdú Tartajo F, Lledo García E, Jara Rascón J, González Chamorro F, Rodríguez Fernández E
Servicio de Urologá, H.G.U. Gregorio Marañón, Madrid.
Actas Urol Esp. 1997 Jun;21(6):590-7.
To evaluate the value of rectal examination, transrectal ultrasound and their association in patients with prostate cancer undergoing radical prostatectomy.
Retrospective study on 56 patients who underwent radical prostatectomy between 1995-1995, mean age 63.2 +/- 10 years, to compare local clinical staging of extracapsular dissemination and seminal vesicle invasion performed by rectal examination and transrectal ultrasound with pathological findings in the prostatectomy specimens. The sensitivity, specificity, VPP, VPN, accuracy and percentage of under- and over-staged patients were assessed.
Prevalence of locally advanced disease was 48%. Sensitivity to detect extracapsular dissemination was significantly higher with ultrasound (38%) than rectal examination (6%). Association of both techniques increased the sensitivity (50%) though not significantly; sensitivity to detect vesicle invasion was very low (14%). Accuracy of ultrasound to establish an overall definition of the local stage was 66%, but 59% patients with locally advanced disease were understaged and only 10% patients with localized disease were overstaged.
Transrectal ultrasound showed low sensitivity to define the locally advanced disease mainly at the seminal vesicle level, with acceptable specificity. Overall evaluation of findings with RE and TRU increase discreetly the efficacy of prostate capsule staging.
评估直肠指检、经直肠超声及其联合应用在接受根治性前列腺切除术的前列腺癌患者中的价值。
对1995年至1995年间接受根治性前列腺切除术的56例患者进行回顾性研究，平均年龄63.2±10岁，比较直肠指检和经直肠超声所进行的前列腺外扩散和精囊侵犯的局部临床分期与前列腺切除标本的病理结果。评估敏感性、特异性、阳性预测值、阴性预测值、准确性以及分期过低和过高患者的百分比。
局部晚期疾病的患病率为48%。超声检测前列腺外扩散的敏感性（38%）显著高于直肠指检（6%）。两种技术联合应用虽未显著提高敏感性（50%）；检测精囊侵犯的敏感性非常低（14%）。超声确定局部分期总体定义的准确性为66%，但59%的局部晚期疾病患者分期过低，只有10%的局限性疾病患者分期过高。
经直肠超声在定义主要为精囊水平的局部晚期疾病方面敏感性较低，特异性尚可。直肠指检和经直肠超声检查结果的综合评估可适度提高前列腺包膜分期的效能。
