数字直肠检查不是一个有用的前列腺癌查测试
Agne Krilaviciute1, Nikolaus Becker1, Jale Lakes2
1Division of Personalized Early Detection of Prostate Cancer, German Cancer Research Center (DKFZ), Heidelberg, Germany.
European urology oncology
|October 8, 2023
概括
数字直肠检查 (DRE) 并不是45岁及以上男性前列腺癌 (PCa) 的有效查工具. 这项研究发现,DRE具有较差的诊断性能,并且在与PSA查一起使用时不会改善PCa检测.
科学领域:
- 泌尿器科 泌尿器科 泌尿器科 泌尿器科
- 在瘤学瘤学.
- 诊断的准确性 诊断的准确性
背景情况:
- 德国建议每年进行数字直肠检查 (DRE),用于45岁及以上的男性进行前列腺癌 (PCa) 查.
- 然而,在这个年龄组中,DRE的诊断性能尚未通过专门的查试验得到验证.
研究的目的:
- 评估DRE的诊断性能,作为45岁以上男性PCa的独立查测试.
- 在前列腺特异性抗原 (PSA) 查的背景下,评估DRE对PCa检测的贡献.
主要方法:
- 在多中心,随机的PROBASE试验 (>46,000名男性) 的前性查手臂中分析DRE性能.
- 在6537名男性中,在45岁时提供了DRE作为一次性查.
- 通过DRE检测PCa与PSA查驱动活检一起进行评估 (n=578).
主要成果:
- 在0.05%的男性中,DRE检测到PCa (3/6537),明显低于PSA查 (0.21%,48/23301).
- 与PSA查相比,DRE的真阳性检测率为0.22,虚阳性检测率为2.2.
- 在通过PSA查检测到的PCa病例中,86%有非可疑的DRE发现 (相对于PSA的相对敏感度为14%).
结论:
- 独立的DRE在45岁男性前列腺癌查方面表现不佳.
- 在年轻男性中,DRE不应被推作为主要的PCa查方法.
- DRE不能提高通过PSA查发现的PCa的检测.
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