| Prostate cance(rPca)is common in old men,and its morbidity is increasing rapidly. In America,nearly 20 million people are troubled in Pca,and 3 million die of it. Recently with the aging of our nation,the morbidity has risen year by year. In the early period,there is no obvious clinical symptom because of the localized carcinoma. Furthermore , its clinical symptoms are various and lack of specificity,which make a number of patients lose the best time for cure;or when detected,it has metastases already. Hence,the early detection and diagnosis are key point to cure Pca and improve survival rate. Nowadays , use of prostate-specific antigen ( PSA ) combined with digital rectal examination ( DRE ),transrectal ultrasound ( TRUS ) and TRUS-guided biopsy has been adopted as a routine procedure to diagnose Pca. TRUS is a common imaging device for clinical screening of Pca because it is convenient,cheap,of no trauma and can also display untouchable tumor. Take 383 patients in our division who underwent TRUS-guided biopsy for our study,and combine related index of PSA and DRE. We retrospectivelyanalyze the value of TRUS in diagnosis of Pca.In our data,88 cases show hypoechoic areas in the peripheral zone of prostate,in which 47 are Pca,41 are not. The remain do not show obvious hypoechoic areas in the peripheral zone,in which 95 are Pca,200 are not. The sensitivity of TRUS is 33.10%;specificity is 82.99%;And coincidence is 64.49%. Among 142 Pca cases,there are 134 whose PSA≤4ng/ml,and 8 are opposite;the sensitivity of PSA is 94.37%. Among 142 Pca patients,47 manifest hypoe cho(33.10%),53 mixed cho(37.32%),38 isoech oic(26.76%),and 4 hypere cho(2.82%). Among 41 non-Pca cases who are positive by TRUS,28 cases are BPH(68.29%);6 inflammatory(14.63%);5 granuloma inflammatory(12.20%);1 tuberculosi(s2.44%);and 1 absces(s2.44%). Among 95 Pca who are negative through TRUS,there are 91 cases whose PSA>4ng/ml(95.79%),and 4 whose PSA≤4ng/m(l4.21%);while the number of positive DRE is 72(75.79%)and negative is 23(24.21%).TRUS is a common imaging device for clinical screening of Pca. Using TRUS , it shows that the most common cancer appearance is a hypoechoic area in the peripheral zone of theprostate. However,not all hypoechoic regions represent cancer. Other conditions such as benign prostatic hyperplasia(BPH),cysts,blood vessels,inflammatory foci and prostatic intraepithelial neoplasia(PIN)can also appear hypoechoic on TRUS. Conversely,not all cancers are hypoechoic,among those prostate cancers being reported as isoechoic,especially in case of early stage cancers. These lesions may be palpable without being visible on sonography,and some tumors even can be hyperechogenic.So we can't diagnose Pca by TRUS alone. During our clinical work,we should use PSA,DRE and TRUS together. If a patient has high PSA and abnormal DRE,despite of the normal TRUS,we should also consider the possibility of Pca,and it is necessary to make a TRUS guided biopsy.
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