数字直肠检查 (DRE) 在前列腺癌诊断中的价值
Adeoye Debo-Aina1, Alexander Martindale1, Juwayriyyah Amjad1
1Urology, Princess Royal University Hospital, King's College Hospital NHS Foundation Trust, London, GBR.
Cureus
|January 9, 2025
概括
数字直肠检查 (DRE) 可能不必用于前列腺癌 (PCA) 诊断. 提升的前列腺特异性抗原 (PSA) 和MRI扫描是关键. 这项研究表明,在PCA诊断途径中可以省略DRE.
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.
- 诊断成像 诊断成像 诊断成像
背景情况:
- 前列腺癌 (PCA) 是男性最常见的癌症.
- 目前的指导方针建议进行数字直肠检查 (DRE) 和前列腺特异抗原 (PSA) 进行PCA诊断.
- 活检前的MRI越来越多地用于PCA评估.
研究的目的:
- 为了评估常规DRE的诊断价值,在接受PCA评估的患者中,通过预活检MRI进行PCA评估.
- 为了比较正常和异常DRE组之间的前列腺癌和临床显著的前列腺癌检测率.
- 评估DRE在PSA和基于MRI的PCA诊断方面的重要性.
主要方法:
- 在PCA诊断途径上对436名患者的回顾性分析 (2019年9月 - 2020年6月).
- 专注于正常MRI (PI-RADS 1-2) 和记录的DRE结果的患者.
- 按DRE状态 (正常与异常) 分类,并比较癌症检测率.
主要成果:
- 总体PCA检测率为10.2%,临床显著前列腺癌 (CSPC) 的4.67%.
- 与正常的DRE相比,异常的DRE显示出更高的,但在统计学上不显著的PCA和CSPC检测率.
- 麦克纳马的测试显示,DRE状态和PCA或CSPC诊断之间没有显著的关联 (分别为p=0.146和p=0.774).
结论:
- 前列腺癌诊断可以在没有DRE的情况下有效地进行.
- 结果支持在远程PCA诊断咨询中省略DRE.
- 重新评估DRE在PCA诊断途径中的作用是有必要的,强调PSA和MRI.
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