Analysis Of Influencing Factors In Diagnose Of Prostate Cancer

Objective To investigate the relevance between the Prostate Sepcific Antigen Density and the positive rate in prostate biopsy,when TPSA was 4-10ng/ml.To evaluate value of DRE,TRUS,mp-MRI in diagnose of prostate cancer.And to evaluate value of the different prostate biopsy approaches(transrectal approach and transperineal approach)in diagnose of prostate cancer,when TPSA was 4-10ng/ml.Methods From 2005 to 2015,851 cases patients underwent ultrasound guided prostate biopsies were selected as research subjects.To contrast the discrimination in PSAD,DRE,TRUS,mp-MRI and different prostate biopsy approaches by sensitivity,specificity and positive rate.Focus on the value of PSAD in diagnose of prostate cancer,when TPSA was in grey zone.The patient was distinguished by different prostate biopsy approaches,named transrectal prostate biopsy and transperineal ultrasound guided templated prostate biopsy.The positive rates and complications of the biopsy were compared between the two groups.In the help of above indicators,to further improve the positive rate in early diagnose of prostate cancer.Results In 851 cases of suspected prostate cancer,the sensitivity of DRE,TRUS and MP-MRI in prostate cancer were 40.2%,61.5%and 83.7%,respectively.And the specificity were 79.6%,68.4%and79.3%,respectively.The positive rate of prostate biopsy was 21.2%,when TPSA was in grey zone.PSAD and FPSA/TPSA were both significantly discriminating between prostate cancer group and benign prostate hyperplasia group.The maximum area under ROC of these indexes was PSAD.The positive rates of transrectal prostate biopsy and transperineal ultrasound guided templated prostate biopsy were 35% and 43.1%,respectively.The latter was significantly higher than the former.Different puncture methods would both lead to different complications.The incidence of the same complication was different in the two puncture pathways.The incidence rates of post-biopsy infection and rectal bleeding were significantly higher in transrectal group.Similarly,the incidence rate of perineal swelling was significantly higher in transperineal groupConclusion 1.PCa is a disease of the elderly,as the likelihood of developing it is associated closely with advancing age Most patients were over 50 years old when they were diagnosed.And we found that the incidence rate was higher in older man.Therefore,it was recommended that elderly men(≥50 years)routinely screen PSA and TRUS.2.Prostate specific(PSA)is the most useful marker for the early detection of prostate cancer(PCa).But its use as a diagnostic marker is controversial because it has several limitations,including its low specificity(PSA levels are also increased in benign prostatic hyperplasia,and in general inflammatory responses)and low sensitivity.Combining PSA,PSAD with FPSA/TPSA ratio can improve the diagnose of prostate cancer.In particular,when PSA was 4-10 ng / ml,PSAD has a higher early diagnostic rate of prostate cancer.DRE,TRUS,CT,multi-parameter MRI and other imaging indicators can improve the positive rate of prostate cancer.3.When PSA was 4-10 ng / ml,the positive rates of transperineal ultrasound guided templated prostate biopsy was remarking higher than transrectal prostate biopsy.And the complications were different.The incidence rates of post-biopsy infection and rectal bleeding were significantly higher in transrectal group.Similarly,the incidence rate of hematuria and perineal swelling was significantly higher in transperineal group.On the other hand,transperineal prostate biopsy is difficult to operate and promote.