The Diagnostic Value Of Ultrasound Quantitative Parameters In Prostate Cancer And Its Correlation With Tumor Markers

Objective:1.To investigate the diagnostic value of strain index(SI),an elastography parameter,for prostate cancer(PCa)and its correlation with the expression of Nuclear related antigen Ki-67(Ki-67)and α-methylacyl-Co Aracemase(P504s);2.To investigate the diagnostic value of quantitative parameters of contrast enhanced ultrasound(CEUS)for PCa and its correlation with the expression of tumor markers Ki-67 and P504 s.Methods:1.67 urological patients who underwent ultrasound-guided prostate biopsy in the First Affiliated Hospital of Medical College of Shihezi University from November 2019 to January 2021 were collected,including 31 patients in PCa group and 36 patients in non-PCa group.All patients were found suspicious nodules in the prostate by transrectal ultrasound(TRUS)or multiparametric magnetic resonance imaging(mp MRI).SI parameters were obtained through quantitative analysis by strain elastography(SE)before systematic puncture biopsy in every patient.With pathological results as the gold standard,the parameter about area under the curve of the receiver operating characteristic curve(ROC)was calculated to evaluate the diagnostic efficacy of SI parameters for PCa.The expressions of Ki-67 and P504 S were detected in the pathological and immunohistochemical examination after biopsy.The correlation between SI parameters and the positive expression rates of Ki-67 and P504 s was evaluated by the Spearman correlation test.2.61 urological patients who underwent ultrasound-guided prostate biopsy in the First Affiliated Hospital of Medical College of Shihezi University from November 2019 to January 2021 were collected,including 28 patients in PCa group and 33 patients in non-PCa group.All patients were found suspicious nodules in the prostate by TRUS or mp MRI.All patients received CEUS before systematic puncture biopsy,then the parameters of CEUS,including basic intensity(BI),arrival time(AT),time to peak intensity(TTP),peak intensity(PI),ascending slope(AS),mean transit time(MTT),descending slope(DS)and amplitude(AMP),were obtained by time intensity curve(TIC)analysis.With pathological results as the gold standard,the parameter about area under the curve of ROC was calculated to evaluate the diagnostic efficacy of every CEUS parameter for PCa.The expressions of Ki-67 and P504 S were detected in the pathological and immunohistochemical examination after biopsy.The correlation between every CEUS parameter and the positive expression rates of Ki-67 and P504 s was evaluated by Spearman correlation test.Results:1.The levels of SI in PCa group were higher than those in non-PCa group.When SI is > 4.27,the sensitivity,specificity,accuracy,and area under the curve were 70.97%,86.11%,79.10%,0.774,respectively.2.SI parameter was positively correlated with the expression of Ki-67(r = 0.449,P < 0.001)and P504s(r =0.409,P < 0.001).3.Among CEUS parameters,TTP(P < 0.001),AMP(P = 0.001),MTT(P < 0.001),AS(P = 0.044)were significantly different between benign and malignant nodules.The parameters of TTP and MTT in PCa group were higher than those in non-PCa group,while the parameters of AMP were lower than those in non-PCa group.When MTT is > 71.01 s,the sensitivity,specificity,and accuracy were 85.71%,75.76%,and 80.33%respectively,and the area under the curve was 0.878.4.The expression of Ki-67 was moderately positively correlated with AMP(r = 0.500,P < 0.001),moderately negatively correlated with MTT(r =-0.537,P < 0.001),but not significantly correlated with TTP and AS(P > 0.05);the expression of P504 s was fair negatively correlated with TTP(r =-0.343,P = 0.007),MTT(r=-0.650,P < 0.001),and fair positively correlated with AMP(r = 0.359,P = 0.004),but there was no significant correlation with AS(P > 0.05).Conclusions:1.SI,the quantitative parameter of SE,has satisfactory diagnostic value for PCa;2.The quantitative parameters of CEUS have satisfactory diagnostic value for PCa,and in these parameters,the MTT has the highest diagnostic efficiency for PCa;3.The quantitative parameters of SE and CEUS are both correlated with the expression of Ki-67 and P504 s.The SI and AMP are moderately positively correlated with the expression of Ki-67 and P504 s,while the MTT,the quantitative parameter of CEUS is moderately negatively correlated with the expression of Ki-67 and P504 s.