[Performance+ of transrectal ultrasonography in the diagnosis of prostatic cancer in patients with abnormal digital examination].
OBJECTIVE
To determine the incidence of prostatic cancer in patients with abnormal digital rectal examination (DRE) and its correlation with PSA levels and US findings.


METHODS
A retrospective study was conducted on 167 patients with abnormal DRE that had been evaluated by PSA, US and prostate biopsy from January, 1994 to September, 1995. The 95% confidence interval was estimated (C195) for the differences observed.


RESULTS
Biopsy demonstrated cancer in 73% of the patients; 67.7% of the patients with DRE classification of T2 versus 88.4% of those with T3 (C195 = 8%-33.3%); 81.4% of patients with PSA > 10 ng/ml had cancer versus 60.5% of patients with PSA > 4 and < 10 ng/ml (CI95 = 3%-37.9%); 79.5% of the cases with ultrasound nodes had cancer vs 43.3% of those without (CI95 = 17.3%-55.2%). In patients with PSA > 4 and < or = 10 ng/ml, 71% of the cases with ultrasound nodes had cancer versus 14.3% with no nodal involvement (CI95 = 26.2%-87.1%). In patients with PSA > 10 ng/ml, 83.2% of the patients with ultrasound evidence of node involvement had cancer versus 70.6% of the patients with no node involvement (CI95 = -10.3%-35.4%).


CONCLUSIONS
The incidence of prostatic cancer in patients with abnormal DRE was 73%; 81.4% of patients with PSA > 10 ng/ml and 79.5% of patients with ultrasound evidence of node involvement and 83.2% of those with both of the foregoing characteristics. Biopsy of both prostatic lobes should be performed routinely in all patients with abnormal DRE.
Herranz Amo
F
F
Servicio de Urología, Hospital General Universitario Gregorio Marañón, Madrid, España.
Diez Cordero
J M
JM
Verdu Tartajo
F
F
Saiz Carrero
A
A
Rodríguez Fernández
E
E
Lledó García
E
E
González Chamorro
F
F
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001706:Biopsy / Q000379:methods; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D010173:Palpation; D017430:Prostate-Specific Antigen / Q000097:blood; D011471:Prostatic Neoplasms / Q000097:blood / Q000000981:diagnostic imaging* / Q000453:epidemiology / Q000473:pathology; D012007:Rectum; D012189:Retrospective Studies; D014463:Ultrasonography / Q000379:methods
D017430:Prostate-Specific Antigen
Rendimiento de la ecografía transrectal en el diagnóstico del cáncer de próstata en los pacientes con tacto rectal anormal.