Analysis Of The Spatial Distribution And Clinical Features Of Prostate Cancer

Background: Currently,most studies on the spatial distribution of prostate cancer are conducted on the distribution of cancer lesions in specimens after radical prostatectomy,and most patients are diagnosed by transrectal prostate biopsy(TRBx),which can distinguish the distribution of cancer lesions between the apex,middle and basal part of the prostate,but the distinction between the left and right sides of prostate cancer and the transitional and peripheral bands remains to be considered.And there has been little research on the specific proportion of cancer in prostate biopsy tissue.In this study,810 patients who underwent transperineal prostate biopsy(TPBx)were included,and we aimed to analyze the clinical characteristics,diagnostic efficacy of relevant indicators,and reveal the spatial distribution of prostate cancer in TPBx.Methods: Collected the clinical data of TPBx patients in our hospital(Oct.2016-Feb.2019),and analyzed the clinical characteristics of prostate cancer,the diagnostic efficacy of relevant indicators,and compared the positive rate of puncture needle(PRPN)at each puncture site,the cancer focus volume ratio(CFVR)and the positive rate of cancer focus(PRCF)under different gleason scores.Results: Age,total prostate specific antigen(t-PSA),prostate volume(PV),prostatic inflammation,dysuria,hematuria,asymptomatic and MRI were independent factors in prostate cancer(Pca)patients compared with non-Pca patients(P<0.05).The cut-off points for age,tPSA,free prostate specific antigen(f-PSA),PSA density(PSAD),free/total prostate specific antigen(f/t PSA)and PV were 73 years old,15.43ng/ml,4.545ng/ml,0.475ng/ml*cm3,0.123 and 41.45 ml,respectively.The PRPN of left peripheral zone(LPZ)was higher regardless of gleason score.The PRPN of left transitional zone(LTZ)was lower than LPZ and similar to right zone(RZ),but PRCF and CFVR was significantly higher,especially in tumors with high gleason score(≥8).Conclusions: For our hospital,The t-PSA standard and the PSAD standard in the puncture indication should be increased,while the f/t PSA standard should be reduced.At the same time,multi-factor assessment is needed to determine whether patients need a prostate biopsy or not.The spatial distribution of prostate cancer is asymmetrical,with more cancer lesion on the left than on the right.The PRPN of LPZ is relatively higher.LTZ has higher PRCF,and most of them were large cancer lesions with high gleason score(≥8).