Study On Early Diagnosis Of Prostate Cancer And Type Of Ultrasound Through Transrectal Color Doppler Ultrasound Combined With MVD, VEGF

Objective: The purpose of this study is observe the hemodynamic changes of prostate nodules through the transrectal color Doppler ultrasound, combined with the observation of the immunohistochemical about microvessel density and vascular endothelial growth factor, it's extremely close with the growth of vascular. To explore the rationality about type of prostate cancer ultrasound, and providing more reliable theoretical basis through transrectal color Doppler ultrasound for early diagnosis of prostate cancer.Methods: To make prostatectomy in our hospital in 2007 -2009,and to be confirmed diagnosis of cases among prostate disease by pathology biopsy .74 cases of Prostate cancer, 25 cases of PIN, 39 cases of hyperplasia.①To analysis retrospectively the cases of prostate cancer two-dimensional and three-dimensional ultrasound images and clinical data, and sort out three types: simple nodular type, nodular infiltrating type, diffuse infiltrating type. And compare the proportion of poorly differentiated among the various types of cancer.②Through color Doppler (CDFI) detect the largest artery systolic blood flow velocity (Vs), resistance index (RI) and pulsatility index (PI) inside or on the brink of various types of lesions, and compare these indexs differences in the sub-type.③Combination of color Doppler (CDFI) to conduct blood classification among the various types (to be divided into four blood flow: zero-order: the scarcity of blood flow signal, showing punctate stars; one-order: more blood flow signal, like cosh, like thin branch; two-order: rich blood flow signals, showing rod-like, branched; three-order: a very rich blood flow signals, showing branches plexiform cluster.). And statistic relativity between the classification of blood and the type.④through the method of immunohistochemical detect the MVD and VEGF protein expression in PIN and sub-type of prostate cancer cases.Results:①The cases of nodular infiltrating type and diffuse infiltrating type of poorly differentiated proportion was significantly higher than the cases of nodular simple(P<0.05). but no significant difference between the two types(P>0.05).②Simple nodular type, nodular infiltrating type, diffuse infiltrative type cancer maximum systolic velocity (Vs), RI and PI was significantly higher than PIN and hyperplasia(P<0.05). Three sub-type cancer hemodynamic changes also varied, simple nodular type Vs must be less than the nodular infiltrating type and diffuse infiltrative type(P<0.05), Between the nodular infiltrating type and the diffuse infiltrative type is no significant difference(P>0.05). About RI and PI, the simple nodular type and diffuse infiltrative type was significantly higher than to nodular infiltration type(P<0.05), the simple nodular type and diffuse infiltrative type is no significant difference(P>0.05). In cancer, the simple nodular type is high resistance and low-speed (compared with other types of cancer nodules), nodular infiltrating type is low resistance and high-speed, diffuse infiltrating type is high resistance and high-speed.③simple nodular type, nodular infiltrating type, diffuse infiltrating type is positively related on the statistical analysis about the blood classification in sequence, Correlation coefficient is 0.522(P<0.01).④MVD count and the positive rate of VEGF expression, strongly positive rates are based on proliferation→PIN→prostate cancer order gradually increased(P<0.05). The expression of positive rate in simple nodular type is relatively low, significantly lower than nodular infiltration type and diffuse infiltration type(P<0.05). Nodular infiltration type and diffuse infiltration type is no significant difference(P>0.05).Conclusion: 1. In the development process about localized prostate cancer from hyperplasia→PIN→simple nodular type→nodular infil- trating type→diffuse infiltrating type, the color Doppler ultrasonography can clearly show the hemodynamic changes in prostate nodule, within the lesions,systolic blood flow velocity getting higher and higher; blood supply was increasingly rich; and getting lower and lower degree of tumor differentiation; MVD count is getting higher and higher; VEGF protein expression growing.2. Transrectal color Doppler ultrasound in early diagnosis of prostate cancer is credible, and explore the use of this type of ultrasound is feasible.