[Current role of prostatic transrectal ultrasound in the diagnosis of CaP]

Cancer of the prostate (PCa) is now recognized as one of the most important medical problems facing the male population. In Europe, PCa is the most common solid neoplasm, with an incidence rate of 214 cases per 1000 men, outnumbering lung and colorectal cancer (1). According to the EAU guidelines, the main diagnostic tools to obtain evidence of PCa include DRE, serum concentration of PSA and transrectal ultrasonography (TRUS). But, does TRUS affect the diagnostic process?

Between March 2007 and March 2011 we performed 441 prostate biopsies to compare the results with clinical, laboratory and ultrasonographic features of every patient. We investigated sensitivity, specificity, accuracy, positive and negative predictive value and likelihood ratio about every diagnostic tool (PSA, DRE and TRUS).

The transrectal ultrasonography has a low diagnostic accuracy for prostate cancer because it shows: Low sensitivity and specificity (higher incidence of false positives than true positives); Variability of ultrasound situations within which the tumor occurs.

In our opinion TRUS may be considered only a complement to PSA and DRE.