Contrast Study On The Detection Rate Of Prostate Cancer After Prostate Biopsy And Transurethral Resection Of The Prostate

Objective:In this study,retrospective analysis of pathological examination results was conducted on patients with tPSA of serum in 4-10ng/ml after prostate biopsy and transurethral resection of the prostate.Both of the prostate cancer detection rates were compared.Moreover,the correlation between the two and t PSA value,f PSA/tPSA value,PSAD value as well as prostate MRI result respectively was compared so as to confirm which way had higher detection rate of prostate cancer and whether there was influence factor in terms of tPSA 4-10ng/ml patients after prostate Biopsy per rectum and transurethral resection of the prostate,which was to provide the basis for treating such patients clinically.Method:Retrospective analysis was carried out on clinical data of 60 cases of prostate cancer suspected patients with serum's PSA value between 4-10ng/ml from December,2012 to December,2015,of which 28 cases were adopted with prostate aspiration biopsy under ultrasonic guidance per rectum,and 32 cases were adopted with transurethral resection of the prostate.All patients' tPSA value,fPSA value,fPSA/tPSA value,prostate volume,PSAD value,prostate MRI result and pathological examination result were recorded.Pathological biopsy's detection rates of prostate cancer after prostate Biopsy per rectum and transurethral resection of the prostate were compared.Comparison was made respectively to see whether there was any difference between the positive patients' tPSA,fPSA,fPSA/tPSA,prostate volume,PSAD and prostate MRI result in the two groups.The influence of tPSA,fPSA/tPSA,PSAD and prostate MRI result on detection rate of prostate cancer was compared respectively in the two groups.1 Each factor of possibly affecting the detection rate of prostate cancerSerum PSA value: including tPSA value,fPSA value and fPSA/t PSA value.Prostate volume: prostate volume=0.52*three-path product(measured via rectum ultrasonic)PSAD value: PSAD=tPSA/prostate volumeProstate MRI result: it was divided into positive and negative based on if there was occupation or periphery infiltration and metastasis.2 Pathological examination methodProstate Biopsy per rectum under ultrasonic guidance: improved prostate 12+x point aspiration method was applied respectively to prostate's left bottom interior,exterior,left middle interior,exterior,left sharp part interior,exterior;right bottom interior,exterior,right middle interior,exterior,right sharp part interior,exterior with one needle for each and a total of 12 needles.Additional 1 needle or 2 could be made on suspected parts like nodule demonstrated by ultrasonic.All the aspirations had been operated and completed by an experienced urological surgeon.After aspiration,the samples were sent for pathological examination.Transurethral resection of the prostate: conventional transurethral resection of the prostate was carried out.The location of excision of prostate in operation was as close to prostate peplos as possible so as to take samples from the peripheral tissues and we should avoid only excising tissues of transition zone.All cases of transurethral resection of the prostate were completed by an experienced urological chief surgeon with high seniority.After transurethral resection,the samples were sent for pathological examination.Result:1 According to the statistics,among the 60 patients with the tPSA between 4-10ng/ml,7 out of 28 patients with prostate Biopsy per rectum were diagnosed as prostate cancer with the positive rate being 25%;7 out of 32 patients with transurethral resection of the prostate were diagnosed as prostate cancer with the positive rate being 21.8%.Through chi-square test,there was no significant difference between the positive rates of prostate cancer in the groups of transurethral resection of the prostate and prostate Biopsy per rectum(P=0.775>0.05).2 As for patients with the positive result of prostate cancer in aspiration group and transurethral resection group,the corresponding P values of tPSA,volume,fPSA,PSAD and f/tPSA through t test were all greater than 0.05 and P values of MRI results through chi-square test were all greater than 0.05 without significant difference.This indicated that there was no difference of relevant indexes in aspiration biopsy and transurethral resection of prostate cancer positive patients.3 The correlation between positive results of prostate Biopsy per rectum under ultrasonic guidance and the results of tPSA,f/tPSA,PSAD as well as MRI positive was with statistical significance(P<0.05);the correlation coefficient of aspiration biopsy positive results and tPSA was rs=0.400,P=0.002<0.05,which indicated that aspiration biopsy positive results had a significant positive correlation with tPSA with statistical significance;the correlation coefficient of aspiration biopsy positive results and f/tPSA was rs=-0.620,P=0.000<0.05,which indicated that aspiration biopsy positive results had a significant negative correlation with f/tPSA with statistical significance;the correlation coefficient of aspiration biopsy positive results and PSAD was rs=0.618,P=0.000<0.05,which indicated that aspiration biopsy positive results had a significant positive correlation with PSAD with statistical significance;the correlation coefficient of aspiration biopsy positive results and MRI positive results was rs=0.554,P=0.000<0.05,which indicated that aspiration biopsy positive results had a significant positive correlation with MRI positive results with statistical significance.The correlation between positive results of transurethral resection of the prostate and the results of tPSA,f/tPSA,PSAD as well as MRI positive was with statistical significance(P<0.05);the correlation coefficient of transurethral resection positive results and tPSA was rs=0.0.460,P=0.001<0.05,which indicated that transurethral resection positive results had a significant positive correlation with tPSA with statistical significance;the correlation coefficient of transurethral resection positive results and f/tPSA was rs=0.0.710,P=0.000<0.05,which indicated that transurethral resection positive results had a significant negative correlation with f/tPSA with statistical significance;the correlation coefficient of transurethral resection positive results and PSAD was rs=0.0.549,P=0.000<0.05,which indicated that transurethral resection positive results had a significant positive correlation with PSAD with statistical significance;the correlation coefficient of transurethral resection positive results and MRI positive results was rs=0.0.561,P=0.000<0.05,which indicated that transurethral resection positive results had a significant positive correlation with MRI positive results with statistical significance.Conclusion:1 In tPSA 4-10ng/ml patients,there is no significant difference in detection rate of prostate cancer between prostate Biopsy per rectum and transurethral resection of the prostate.2 The indexes of tPSA,fPSA/tPSA,PSAD and MRI results cannot decide to adopt prostate Biopsy per rectum or transurethral resection of the prostate for diagnosing prostate cancer.3 No matter which way is going to taken for pathological biopsy,the detection rate of prostate cancer is always positively associated with PSA,negatively associated with f/tPSA,positively associated with PSAD and positively associated with MRI positive results.