A Preliminary Study On The Relationship Between Contrast-enhanced Ultrasonography And Microvessel Structure In Prostate Cancer

Objective:1.To explore the correlation between the quantitative parameter PI value of contrast-enhanced transrectal ultrasonography and the morphological structure of microvessels in tumor tissue and ISUP grade of prostate cancer with different contrast enhancement levels.2.Preliminary exploration of the microvascular structure differences in tumor tissues of different ISUP grades of prostate cancer,and analysis of the correlation between ISUP grades and tumor microvascular morphology.Methods:61 patients with prostate cancer whose serum total prostate specific antigen(T-PSA)was higher than 4ng/ml and were confirmed by prostate biopsy under the guidance of transrectal ultrasonography from January2019 to June 2020 in the first affiliated Hospital of Guangxi Medical University were analyzed retrospectively.All patients underwent transrectal contrast-enhanced ultrasonography before puncture biopsy,and the contrast images were analyzed by TIC analysis software,and the peak intensity(PI)of the quantitative parameters of the contrast curve was recorded.International Society of Urological Pathology(ISUP)recommended classification group was selected for prostate cancer tissue obtained by targeted puncture in each patient The samples with the highest grade were stained with CD31immunohistochemistry,and the microvascular structure was observed and classified.According to the enhancement level of contrast enhanced transrectal ultrasound,they were divided into low-enhancement group and high-enhancement group.The differences and correlations of PI value,ISUP grade,microvascular morphology and structure between the two groups were analyzed.According to the results of ISUP grade,the cases were divided into group A(ISUP grade 1 and 2),group B(ISUP grade 3),and group C(ISUP grade 4 and 5),and the differences in the microvascular structure characteristics of prostate cancer tumor tissues among the three groups were analyzed.Preliminary exploration of the correlation between ISUP grade and tumor microvascular morphology.Results:1.There were 16 cases in the low-enhancement group and 45 cases in the high-enhancement group.The high-enhancement group ISUP grade,relative mature blood vessel number,MVD,the proportion of relative mature blood vessel,PI value are all higher than the low-enhancement group,the number of immature vessels is relatively low,the enhancement is low(P<0.05);there is no significant number of immature vessels between the two groups Difference(P>0.05).2.The PI value is positively correlated with the number of relatively mature blood vessels(r=0.340),but has no correlation with MVD,the number of immature blood vessels,the proportion of relatively mature blood vessels,the proportion of immature blood vessels,and the ISUP grade.3.There were 13 cases in group A,16 cases in group B,and 32 cases in group C.The number of immature blood vessels and MVD in the tumor tissues of group A and C,group B and C were statistically different(P<0.05).The number of immature blood vessels and MVD in the tumor tissue of group C were higher than those of groups A and B.However,there were no differences in the number of immature blood vessels and MVD in tumor tissue between group A and group B.There were no significant differences in the number of relative mature blood vessels,the proportion of relative mature blood vessels,the proportion of immature blood vessels,and the PI value among the three groups(P>0.05).4.ISUP grade is positively correlated with the number of immature blood vessels and MVD of tumor microvessels(r_s=0.465;r_s=0.417);ISUP grade is not correlated with the number of relative mature blood vessels,the proportion of relative mature blood vessels,and the proportion of immature blood vessels.Conclusion:1.The more abundant the microvessels and the more immature blood vessels in prostate cancer,the worse the prognosis.2.The enhancement level of transrectal prostate ultrasound is mainly related to the relative mature blood vessels of the lesion.The PI value can reflect the relative mature blood vessel condition of the lesion,but it cannot accurately reflect the MVD situation in the lesion.3.The PI value of abnormal prostate ultrasound contrast did not become an accurate indicator to predict the ISUP grade of tumor tissue.