Study On The Diagnostic Value Of MRUS-TB Technology For Clinically Significant Prostate Cancer In People With Low-risk PSA

Objective: Comparative analysis of the detection rate of prostate cancer between MRUS-TB and COG-TB in PSA4ng/ml~20ng/ml population to evaluate whet her MRUS-TB can help to increase the detection rate of clinically significant prostate cancer(CSPCa)-The clinical value of TB in targeted biopsy of patients with low-risk PSA value.Methods: A retrospective analysis of 298 patients with prostate cancer who underwent targeted puncture at the Cancer Hospital of Tianjin Medical University from August 2015 to February 2020,PSA levels of 4ng/ml~20ng/ml,of which 185 patients underwent MRUS-TB and prostate routine system Puncture biopsy(SB)(study group);COG-TB and routine prostate biopsy(TRUS-SB)(contr ol group)were performed in 113 cases.A comparative analysis of the detection rate of targeted puncture prostate cancer and the length of puncture tissue samples of the two groups,and analysis of the impact of the lesion area,prostate cancer tumor volume and Gleason score on the detection rate.Results: 1.The overall detection rates of prostate cancer in the study group(MRUSTB group)and the control group(COG-TB group)were 84.8%(157/185)and 79.6%(90/113),respectively,the difference was not statistically significant(P=0.516);The detection rates of clinically significant prostate cancer in the two groups were 75.7%(140/185)and 72.5%(82/113),and no statistical difference was found(P=0.498);The total detection rate of prostate cancer in the study group(MRUS-TB group)and the control group(COG-TB group)according to PSA4~10ng/ml,10~20ng/ml were 83.2%(124/149),91.7%(33/36);77.9%(60/77),83.3%(30/36);the difference is statistically significant(P=0.033);The total detection rate of prostate cancer in the study group(MRUS-TB group)and the control group(COG-TB group)was 85.7%(24/28)and 88.2%(88.2%)according to prostate volume <20ml,20-40 ml,> 40 ml 105/119),73.7%(28/38);80%(8/10),81.3%(74/91),66.7%(8/12);the difference was statistically significant(P=0.033);2.The detection rate of clinically significant prostate cancer in the research group(MRUS-TB group)and the control group(COG-TB group)is 4 ~ 10n g/ml in PSA,and the proportion of 10~20ng/ml is 80.0%(112/140),20%(28/140);65.9%(54/82),34.1%(28/82);the difference was statistically significant(P=0.019);The detection rates of clinically significant prostate cancer in the study group(MRUS-TB group)and the control group(COG-TB group)were 15.7%(22/140)of prostate volume <20ml,20-40 ml,> 40 ml 67.9%(95/140),16.4%(23/140);8.5%(7/82),84.1%(69/82),7.3%(6/82);the difference was statistically significant(P=0.028);.3.The median length of tumor puncture tissue samples in the study group and the control group(COG-TB group)were 8mm(0.2-19mm)and 7.5mm(0.25-16mm),respectively,the difference was statistically significant(P = 0.040);The positive rates of puncture needles in the study group(MRUS-TB group)and the control group(COG-TB group)were 75.5% and 59.3%,respectively,the difference was statistically significant(P<0.01);4.Among the nodules with the largest diameter less than 5mm in MRI images,the detection rates of clinically significant prostate cancer in the study group(MRUS-TB group)and the control group(COG-TB group)were 66.6%(24/36)and 39.2%(11/28),the difference is statistically significant(P=0.043);5.Clinically significant prostates in the study group(MRUS-TB group)and the control group(COG-TB group)on transition zone,peripheral zone(tip),peripheral zone(middle),peripheral zone(bottom),and peripheral zone(all areas)The cancer detection rates were: 66.6% vs 73.7%,72.0% vs 80.7%,72.0% v s 76.1%,71.4% vs 75.0% and 71.9% vs 77.1%,the differences were not statistically significant(P>0.05).Conclusions: 1.MRUS-TB and COG-TB targeted puncture have no statistically significant difference in the detection rate of clinically significant prostate cancer;2.Compared with the COG-TB group,MRUS-TB can increase the detection rate of clinically significant prostate cancer in patients with gray areas of PSA expression,and can also increase the detection rate of clinically significant prostate cancer in patients with smaller prostate volume;3.Compared with COG-TB,MRUS-TB single needle puncture has a higher detection rate and increases the length of malignant tumor puncture tissue sample s;4.Compared with COG-TB,MRUS-TB can increase the detection rate of clinically significant prostate cancer<5mm nodules;5.MRUS-TB and COG-TB have no statistics on the detection rate of clinically significant prostate cancer in the transition zone,peripheral zone(tip),peripheral zone(middle),peripheral zone(bottom),and peripheral zone(all areas)Learn the differences.