Correlation Analysis Between Image Analysis Of Periprostatic Fat And Reduction Of GS To 7 After Laparoscopic Radical Prostatectomy With GS?8

OBJECTIVE:This study was to explore the relationship between the area and grayscale of periprostatic adipose tissue measured by T2 magnetic resonance imaging(MRI)and the changes of Gleason's score after laparoscopic radical prostatectomy in patients with biopsy pathological Gleason score?8.MATERIALS AND METHODS:A total of 301 patients with prostate cancer were review from the urology department of the General Hospital of the first affiliated Hospital of Soochow University from January 2015 to February 2019.Among them,thirsty-six patients with prostate cancer who met the inclusion criteria were enrolled as the study subjects.The age,height,body weight,preoperative PSA,fPSA,grade(Gleason score),prostate volume and postoperative pathological grade were collected and recorded.The areas and grayscales of periprostatic fat in transverse section of femoral head and greater trochanter of femoral head,periprostatic fat in middle transverse section and periprostatic fat in sagittal position were measured in MRI T2 weighted images.The patients were divided into two groups according to whether GS was reduced to 7 after surgery.T-test analysis,Spearman or Pearson correlation analysis were used to compare the difference and correlation of periprostatic fat area,grayscale measurement index and clinical data between prostate cancer group with postoperative GS downgraded to 7 and postoperative GS not downgraded to 7.RESULTS:(1)There was no significant difference among age,BMI,prostate volume,PSA,fPSA and PSAD between patients with postoperative GS downgraded to7 and those not downgraded to 7(P>0.05).(2)There was no significant difference of periprostatic fat area in sagittal position,periprostatic fat area in middle cross section,periprostatic fat area in transfemoral head and greater trochanter section between patients with postoperative GS downgraded to7 and those not downgraded to 7(P>0.05).(3)There was no significant difference of the mean and median gray level of periprostatic fat in the sagittal position,the median gray level of periprostatic fat in the middle cross section,and the mean and median value of periprostatic fat in the transverse section and greater trochanter of the femoral head between patients with postoperative GS downgraded to7 and those not downgraded to 7(P>0.05).But,between the downgraded and undowngraded patients,the average grayscale of periprostatic fat in the middle cross-section showed significant difference(P=0.041),and the average grayscale value of periprostatic fat in the middle cross-section was positively correlated with the postoperative GS downgraded to 7(r=0.342,P=0.041).CONCLUSION:For prostate cancer patients with biopsy pathological GS of 8?10,19.4%had GS downgraded to 7 after laparoscopic radical prostatectomy.The average grayscale of periprostatic fat in the middle cross-section on T2 weighted images on MRI can be used as an independent predictor of postoperative GS downgrading to 7 in prostate cancer patients with biopsy pathological GS of 8?10.It is positively correlated with GS downgrading to 7.The measurement of the average grayscale of periprostatic fat in the middle cross-section is helpful to predict the change of GS after radical prostatectomy in patients with biopsy GS 8?10,and it provides an evidence for further therapeutic decision and prognostic evaluation.