| Objective:Discusses series of serum PSA and TRUS and prostate biopsy guided by 6+X point method for the clinical diagnostic value of prostate cancer.Method:(1 Retrospective analysis between December 2012 and December 2014,229 cases of PSA> 4 ng/ml or digital rectal ammonites and abnormal nodules and (or) TRUS or magnetic resonance (NMR) found that prostate have abnormal echo tubercle clinical suspected patients with prostate cancer. Compare tPSA, digital rectal (DRE), ultrasound, and the sensitivity of the guided puncture, specific degree, positive rate and other indicators.Serum tPSA at 0 to 4ng/ml,4-10ng/ml,10 to 30ng/ml,>30ng/ml group, and compare between groups of prostate positive rate of biopsy. Compare serum tPSA within 4-30 ng/ml series of PSA in the group of benign prostate hyperplasia and prostate malignant between the presence of differences, and calculate the presence of statistical significance;And according to the serum PSA series of ROC curve analysis, compare the differences of the reference index of diagnosis efficiency. Observed under by transrectal ultrasound color doppler blood flow to the prostate gland and its classification, and to measure the size of the prostate, observe its morphology, comparison between prostate cancer and prostate cancer group differences. (2) 229 patients were performed TRUS-guided biopsy systems 6-point and 6+X biopsy, Compare the two puncture positive difference and statistical indicators.Result:229 suspected patients with prostate cancer tPSA the sensitivity of the diagnosis of prostate cancer was 69.83%,42.48%, DRE sensitivity for diagnosis of prostate cancer was 64.66%,34.51%, the sensitivity of ultrasound in the diagnosis of prostate cancer was83.62%,81.41%.Positive rate in prostate biopsy was 14.29% when tPSA was 0-4ng/ml.The rate was35.53% when tPSA was 4-10ng/ml. The rate was 58.44% when tPSA was 10-30ng/ml. The rate was 85.29% when tPSA>30ng/ml. TPSA between 4-30 ng/ml, benign hyperplasia and prostate cancer group PSAD and fPSA/tPSA have significant difference, P values were 0.021 and 0.003.Area under the ROC curve were 0.589 and 0.650.Prostate cancer and prostate cancer group in two-dimensional ultrasound images (prostate size and blood flow condition, etc.) the difference was statistically significant (P< 0.05). (2) 229 suspected PCa111 was confirmed by biopsy in patients with prostate cancer, BPH99 cases,6 patients with prostatitis, the prostate hyperplasia with inflammatory 8 cases, spindle cell tumor of the prostate 1,3 from the prostate, cases of atypical hyperplasia in 1 case. Line 6+ X puncture biopsy method 100%, sensitivity was 95.69%, the positive detection rate of prostate cancer by 48.47%.111 prostate cancer patients, such as only by 6 points system method of puncture biopsy there will be 12 patients will miss, the missed diagnosis rate was 10.81%.Conclusion:Ultrasound as an index of the diagnosis of prostate cancer with a high degree of sensitivity and specific. Although tPSA and DRE diagnosis of prostate cancer has high sensitivity, but its specific degree is low. The positive rate of prostate biopsy with the increase of tPSA level and gradually rise. tPSA in 4-30ng/ml range, compared with tPSA, PSAD and fPSA/tPSA to identify the accuracy of the prostatic hyperplasia and prostate cancer has improved significantly. By transrectal color doppler examination of the prostate, for the differential diagnosis of benign and malignant lesions of the prostate has good clinical value.6+X-point biopsy method under the guiding of TRUS can improve the detection rate of prostate cancer. And the checking method can clearly benign and malignant lesions of the prostate, and make a pathological diagnosis, for clinical diagnosis, differential diagnosis and treatment of choice to provide pathological basis. |
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