| Objective To investigate the value and significance of the length of intravesical prostatic protrusion(IPP) measured by transrectal ultrasonography(TRUS) combined with serm prostate specific antigen on diagnosis of prostatic cancer(PCa). To investigate the predictive significance of the length of IPP measured by TRUS on bladder outlet obstruction(BOO) and the change of function of detrusor muscle.Methods 1. Data of seventy-one patients with prostate biopsy indications who came to the department of Urology of our hospital from Spetember 2010 to January 2011 were collected.Clinical data include prostatic volume,volume of transition zone and IPP measured by TRUS. Preoperation serum PSA was detected using chemiluminescent method. I-PSS and QOL scores of these patients were enrolled. Patients were divided into BPH group or PCa group based on the results of transrectal-ultrasound guided biopsy results.IPP,TPSA,f /T, PSAD, PSA-TZ in the two groups were analyzed.Their Sensitivity and specificity rate of different levels were respectively calculated to make sure the best cut–off point in the diagnosis of PCa . Combined with the AUC of ROC curves,each index was compared between PCa group and BPH group.2. The thirty seven patients of seventy one patients underwent urodynamic tests.The parameters of urodynamic study were gained .The relations between urodgnamic parameters and IPP as well as other PSA indices were analyzed.Reasuls 1.⑴. In a total of 71 cases,there were 22 patients with PCa and 49 patients with BPH. The PCa positive rate was 30.99%.The IPP average value were 9.3±7.3mm in total patients,6.6±5.0mm in PCa patients,and 11.5±8.4mm in BPH patients. ⑵.Between PCa and BPH groups,there was statistical difference in IPP,PV and PTZV ( P < 0.05).⑶. If taking IPP 7.5mm as the cut-off point,PCa can be dignosed with highest specificity and sensitivity.⑷. Among 35 patients whose IPP were less or equal to 7.5 millimeter there were 15 cases with prostatic cancer.The PCa positive rate was 42.9%,while there were only 7 patients of PCa with the PCa positive rate of 19.4% among 36 cases with IPP more than 7.5mm.The PCa positive rate of patients with IPP less or equal to 7.5mm was statisfically different from that of patients with IPP more than 7.5mm.⑸. The best sensitivity on diagnosing PCa was 96.7% when IPP was combined with PSAD for a parallel test.⑹.The specificity reached the highest of 89.5% when IPP was combined with PSATZ for a serial test with a positive likelihood of 5.24.2. IPP was positively correlated with PV(r=0.691,P < 0.05),with Pdet.max(r = 0.569,P = 0.016) and with BOOI (r = 0.566,P = 0.027),while it was negatively correlated with Qmax(r = -0.261,P < 0.05).Conclusions 1. IPP is a valuable parameter to diagnose PCa in patients with prostate biospsy indications.There is a high PCa detection rate on TRUS prostate needle biopsy among patients with IPP no more than 7.5 mm.2. The PCa detecting sensitivity and specificity can be enhanced by combining IPP with PSAD parallelly or with PSATZ serially.3. IPP could be used to estimate BOOand the function of detrusormuscle. |
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