Objective:Prostate cancer is one of the major causes of cancer death in men in Europe and the United States in recent years, the incidence of PCa is increasing year by year, has been a serious threat to China’s elderly men’s health and life.In view of this, this article in accordance with the following aspects of the discussion.:1ã€to investigate the transrectal real-time elastography imaging technology(TRTE) elastic scoring method and elastic strain index method strain index(SI) and lesions of the average strain index(ASI) lesion and the peak strain index(PSI) of benign and malignant lesions of the prostate diagnosis value and comparison;2ã€to explore the correlation between the elastic scoring method and Gleason classification;3ã€Comparison of elastic and elastic strain index in diagnosis of benign and malignant lesions of the prostate;4ã€to predict the clinical value of the clinical application of the rectal real-time elastic imaging technology.Method:1.From March 2013 to September 2015, the income of the first clinical medical college of Shanxi Medical University Department of Urology 86 cases of serum PSA(prostate specific antigen) in patients with elevated,to diagnose benign and malignant diseases of the prostate by elastic grading method, and the results were compared with pathologic findings;then the quantitative analysis of TRTE, ASI and PSI respectively,compared with pathologic results, compare the value of ASI and PSI in the diagnosis of benign and malignant prostate lesions.2.The elastic classification method, ASI and PSI results of the three groups were compared to two two, there was no statistical difference between the three methods of analysis of benign group and malignant group.3.The elastic classification is divided into V-grade, elastic grade I-II as benign, elastic grade III-V grade as malignant, all lesions were confirmed by pathology and biopsy, the pathological diagnosis of malignant lesions, the relationship of elasticity grade and pathological Gleason classification.4.Comparison the value of elastic classification method, the value of ASI and PSI in the diagnosis of benign and malignant prostate lesions.Result:1.There were statistically significant differences between the elastic classification method in diagnosis of prostate lesions benign group and malignant group(Z=-11.923,P=0.000); ASI and PSI diagnosis method for the diagnosis of prostate lesions between benign group and malignant group were statistically significant(ZASI=--7.637,PASI=0.000; ZPSI=-8.003, PPSI =0.000).2.Prostatic malignant lesions and benign lesions mean ASI were(2.569 ± 1.190)(0.933~ 5.170) and(1.746±0.782)(0.750~3.560), the area under ROC curve was 0.717(95% CI:2.183~ 2.954), the difference was statistically significant(P =0.001).Malignant lesions and benign lesions mean PSI were(8.191±3.596)(1.000~15.720) and(3.082±2.261)(0.870~10.160), the area under ROC curve was 0.866(95% CI:7.025~9.357), the difference was statistically significant(P = 0.000).The area under PSI curve is greater than the area under the ASI curve, the diagnosis is more significant when the optimal ASI value was 2.14, the diagnostic sensitivity was 64%, specificity was 77%; the best when the PSI value was 2.714, the diagnostic sensitivity was 87.2%, specificity was 85.1%.3.Elastic classification method for correct diagnosis of PCa and pathological results of malignant lesions there is a relationship between the scores of Gleason, Spearman rank correlation analysis, positive relationship, rs=0.618,P=0.0001, the difference was statistically significant.Conclusion:1.Transrectal real-time elastography can give the tissue hardness in its mechanical properties, guided biopsy can greatly improve the detection rate of early PCa,and this is not provides by traditional ultrasound.2.The differential diagnosis of ASI and PSI is helpful to the benign and malignant prostate lesions, under the same conditions, the sensitivity and specificity of PSI diagnosis for the clinical diagnosis of PCa is higher, more meaningful.The guided biopsy is more targeted, can greatly improve the positive rate of biopsy.3.There was a significant relationship between elastic grading and Gleason score can be used as a guided biopsy basis, while the elastic hardness is greater, the higher the Gleason score, the higher the degree of malignant lesions, and to provide evidence for clinical treatment. |