The Value Of Transrectal Ultrasound Elastography In The Diagnosis Of Prostate Cancer

Objective:To compare transrectal ultrasound elastography with digital rectal examination,serum prostate specific antigen and MRI in the diagnosis of prostate cancer,and to analyze the value of transrectal ultrasound elastography in the guidance of prostate biopsy and diagnosis of prostate cancer.Method:The clinical data of 307 patients suspected of prostate cancer between January2018 and October 2019 in the second Department of Urology,the First Hospital of Jilin University were analyzed retrospectively.The data of medical history,digital rectal examination,serum PSA level,imaging data and prostate puncture pathology were collected.To compare the efficacy of ultrasound elastography,digital rectal examination,PSA level and MRI plain scan in the diagnosis of prostate cancer.To analyze the correlation between ultrasound elastography score and the number of positive biopsy samples and Gleason score of prostate patients.To analyze the association between elastography color of biopsy area and prostate cancer.Result:A total of 307 patients were included in this study.After pathological diagnosis,119 cases(38.8%)of prostate cancer were confirmed.The analysis showed that the ROC AUC of ultrasound elastography in the diagnosis of prostate cancer was 0.858,the 95% confidence interval(CI)was 0.813-0.895,P< 0.001.It was found that when the elastography score was more than 3,the sensitivity and specificity of prostate cancer diagnosis were the best.The sensitivity was 73.95%,95% CI 65.1-81.6,the specificity was 86.70%,95% CI 81.0-91.2,the positive likelihood ratio was 5.56,thenegative likelihood ratio was 0.30,and the Youden index was 0.6065.The ROC AUC was 0.868,0.785,0.684 and 0.639,respectively.It was found that the value of elastography score in the diagnosis of prostate cancer was the highest,and the difference was statistically significant(P< 0.001).Spearman correlation analysis showed that there was a significant positive correlation between elastography score and the number of positive biopsy samples in patients with prostate cancer(r=0.704,P<0.001),and there was a significant positive correlation between elastography score and Gleason score of prostate cancer pathology(r=0.515,P<0.001).A total of 3126 needle biopsies were performed in the study,including 1013 in the blue area and 2113 in the non blue area.Among the 1013 stitches in the blue area,662 were diagnosed with PCa(65.4%)and 351 were non cancerous(34.6%);among the 2113 stitches in the non blue area,113 were diagnosed with PCa(5.3%)and 2000 were non cancerous(94.7%).Chi square test of matched samples showed that there was a significant correlation between the appearance color of biopsy site and prostate cancer.The proportion of cancer tissue in blue area was higher than that in non blue area(P<0.001).Conclusion:(1)Transrectal ultrasound elastography has high sensitivity and specificity in the diagnosis of prostate cancer,and has important value in the diagnosis of prostate cancer.(2)There was a significant correlation between ultrasound elastography score and Gleason score of prostate cancer.(3)The positive detection rate of prostate cancer can be improved by ultrasound elastography assisted prostate biopsy.