前立腺癌のスクリーニングにおける経直腸的超音波断層法の診断精度

概要

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55歳以上の男子3,219人を対象に,一次検診で経直腸的超音波断層法・耳血濾紙法PSA・直腸内指診,二次検診でsystematic biopsyを用いて行った 1)前立腺癌の検出率は0.8%であり,検出された前立腺癌は全て臨床期の癌である. 2)前立腺癌に対する経直腸的超音波断層法のsensitivityは80%, specificityは98%, positive predictive valueは23%と診断精度は良好であり,PSAと比較した場合,今回の検討結果では全体的に同等の成績であったBetween January, 1994 and December, 1995, we performed systematic biopsy of the prostate in a secondary study of our mass screening program for prostatic diseases. Of the 3,219 males over 55 years of age, 25 patients with prostatic cancer (11 in stage B, 10 in stage C and 4 in stage D) were detected. Herein, the diagnostic accuracy of transrectal ultrasonography (TRS) was compared with that of prostate specific antigen (PSA) and digital rectal examination (DRE). The sensitivity of TRS, PSA and DRE for cancer were 80%, 84% and 64% respectively. The specificity, positive predictive value and accuracy of TRS for cancer were higher than those of PSA or DRE.