The Clinical Research Of Transrectal Ultrasound Prostate Biopsy

Objective:To understand the advantages and disadvantages of transrectal ultrasound (TRUS) guided prostate biopsy and to evaluate the clinical value of the biopsy indications.Materials and Methods:194 patients with suspected prostate cancer from January 2008 to October 2009 were enrolled and were examined by TRUS guided prostate biopsy. The clinical data were collected, including the complications of prostate biopsy and the impact of DRE, TRUS and PSA on the positive rate of prostate biopsy.Data were analyzed by SPSS 17.0.Result:among the 194 patients,38 of them had transient gross hematuria,20 had hematochezia, and all of them got right within 2 to 3 days without special treatment. By using antibiotic and symptomatic treatments for 2-3 days,16 patients with fever were recoveried.5 patients with sepsis were cured within 7days after anti-inflammatory, catheterization, rehydration and symptomatic treatments. There were no hematospermia, prostate abscess and other complications. The cancer positive rate of prostate biopsy was 54.8% in positive DRE patients, while it was 33.0% in patients with prostate hypoechoic nodules. The positive biopsy rate in the peripheral zone nodules was significantly higher than that in the transitional zone (P<0.05). The Spearman rank correlation analysis showed that there was a negative correlation between TPV and the positive biopsy rate (r=-0.38, P<0.05). The positive biopsy rate was 8.3% when the serum levels of PSA was between 4-10ng/ml, while it was 38.0% when PSA>10ng/ml, whereas it was 100% when PSA>100ng/ml.Conclusions:There were complications and risks for prostate biopsy, therefore it is necessary to carefully weigh the benefits and risks before choosing this procedure. That positive DRE, or hypoechoic nodules in TRUS, or PSA>10ng/ml alone serves as a single absolute indicator for prostate biopsy is not conciderable. It is propositional to increase the number of biopsy needles when TPV>50ml. Elderly patients with PSA>100ng/ml and with poor physical condition or those who do not agree with prostate biopsy,It can be considered treatment according to prostatic cancer without biopsy. Comprehensive consideration should be applied when choose procedures between DRE, TRUS or PSA, which will not only improve the positive rate of prostate biopsy, but also reduce the rate of misdiagnosis as well as avoid unnecessary biopsy and alleviate patients'financial burden.