| Background:The prostate is male peculiar gonad organs,It is very rare that have inside and outside double secretory function sex secretion glands.Carcinoma ofProstate is the male reproductive system the most common malignant tumors,Incidence increased along with the age growth and it is clear regional variations,and it is the higher in Europe and America.Along with our country in recent years intensifying aging population,Rapid increase of carcinoma of Prostate.Carcinoma of Prostate etiology yet to be identified,Maybe there is rilation between genetic, environmental, hormones and other relevant.At the early stages of carcinoma of Prostate,There are not a little symptoms with patients. Along with the development of the illness,The patient might notice the following situations: Frequency, urgency; Urinary retention; Burning sensation; Urine flow anomalies; hematuria; Urine pain; Bone pain.Carcinoma of Prostate patients may also contain the following late some complex condition:Marrow depression Osteoma transfer,paraneoplastic syndromes,pain and so on.In our country,Due to the regions and economic differences,There is not enough attention to the carcinoma of Prostate,so they found the illness at the different age.So some patients didn't get the correct diagnosis at early,As hyperplasia of prostate and prostatitis treatment,Maybe could temporarily improve some symptoms,but the actual has delayed treatment optimal opportunity.Carcinoma of Prostate diagnosis method is in the continuous development,Digital rectal examination; ultrasounds,Isotope scanning,Serum acidic phosphatase determination,X-ray,MRK,PSA,Prostate biopsy and so on.Prostate biopsy is accepted and as the gold standard in the diagnosis of Carcinoma of Prostate[2]in currently. Provides an important basis for the diagnosis and treatment of carcinoma of Prostate.Objective:To investigate the relation of the prostate specific antigen (PSA) level with the outcome of analgesic transrectal ultrasound-guided prostate biopsy (ATUGPB) by intravenous anesthesia and clinical parameters in the older men with evaluated PSA.Methods:The AUGPB with twelve cores by intravenous anesthesia were completed in 106 patients September 2008-2010 August our outpatient and inpatient(mean age 68±7years) with evaluated PSA (>4ng/ml). According to the PSA level, the patients were divided into A group (4ng/ml<PSA<10ng/ml,55cases), B grdup(10ng/ml<PSA<20ng/ml,27 cases) and C (PSA>20ng/ml,24 cases). The parameters were recorded including biopsy time, visual analog pain scale score (VAS), prostate volume (PV), PSA density (PSAD), pathological outcome, anesthetic adverse events and complication.Results:The mean biopsy time is 5.9±2.0min, seventy eight cases (93%) have no pain (VAS=0) and no case occurred anesthetic adverse events. There were total 164 positive cores in 1272cores, of which 36 cases were prostate cancer (Pea),4cases were prostate atypical hyperplasia and 4 cases were prostate intraepithelial neoplasia. The detection rate of Pea from A group to C group were respectively 10.7%,33.4% and87.4%, and that of benign prostatic hyperplasia (BPH) were 82.1%s 59.2%and 4.2%, the difference of them is significant (P0＜.05). The PV and mean age (48±1cm3and 65±7 years) of the cases with BPH in A group were significantly lower than those in B group (87±14 cm3 and 73±5 years). Moreover, the PSAD was significantly increasing in the cases with Pea from A group to C group(0.18±0.05ng/ml.cm3,0.21±0.04ng/ml.cm3 and 0.49±0.04ng/ml.cm3). Furthermore, the PSAD of the cases with Pea was significantly higher than that of the cases with BPH, however, PV was significantly lower than that of the cases with BPH from both A group and moderate-risk group. The incidence rate of macroscopic hematuria, bloody stool and fever were respectively 55%,15%and 5%.ConcIusions It is suggested that it is painless and safe for ATUGPB by intravenous anesthesia in the older men with evaluated PSA. The PSA level is well relation with pathological outcome and PSAD could serve as an effective predictive parameter. |
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