| ContextProstate cancer is a common malignant tumor in urology,for it is a daily-growing incidence, prostate cancer has become the hot topic in urology in the world. Although China is one of the low incidence of prostate cancer, but it is rising quickly.In the city, the prostate cancer has become the most common non epithelial tumor. In some hospital screening for prostate cancer is usual, the diagnosis of prostate cancer had obviously improved. The current commonly used a lot of auxiliary examination methods of screening for prostate cancer, but its sensitivity and specificity is poor reference a single indicator. Clinical is more comprehensive DRE, ultrasound and biochemical examination on a digital rectal exam results of prostate cancer to make preliminary diagnosis, decide whether or not to do further pathology examination. Prostate biopsy is considered to be the gold standard for clinical diagnosis of prostate cancer. Methods of prostate biopsy at present are varied, but all have defect in missing diagnosis or excessive penetration.Objective:(1)To assess the guiding significance of DRE positive, TRUS found low echo nodules in transrectal ultrasound(TRUS) guided prostate biopsy, and to analyzes its clinical value of diagnosis.(2) To compare 12-cores and extended 12-cores prostate biopsy in the value of different PSA level in the diagnosis of prostate cancer. (3) To evaluate the complications related to diabetes after transrectal ultrasound(TRUS) guided prostate biopsy.MethodsFrom September 2010 to August 2015,306 TRUS guided prostate biospsies were performed in the Bethune’s second hospital of jilin university.12 patients without complete clinical data were excluded, the remain 294 patients were selected in the study.181 patients received 12-cores prostate biopsy,113 patients received extended 12-cores prostate biopsy. The clinical data were collected,including the complications of prostate biopsy and the impactof DRE,TRUS and PSA on the positive rate of prostate biopsy.Date were analyzed by SPSS 19.0. All statistical tests were two-sided with a P<0.05 considered statistically significant.Results:1 Preoperative DRE found nodules in 66 patients,230 cases by transrectal ultrasound found low density nodules.77 cases with a history of diabetes. The cancer positive rate of prostate biopsy was 60.3% in positive DRE patients, the cancer positive rate of 12-cores prostate biopsy and extended 12-cores prostate biopsy groups were 35.7%and 53.7%,respectively(P<0.05).The positive biopsy rate was 13.7% when the serum levels of PSA was between 4-10ng/ml, while it was 17.3% in patients when the serum levels of PSA was between 10-20ng/ml. When PSA between 10-20 ng/ml, with PSAD> 0.15 as a standard clinical puncture, the positive biopsy rate was 26.4%.2 The rate of complications of patients with diabetes after prostate biopsy is 29.9%(23/77), the rate of complications of patients without diabetes after prostate biopsy was 28.6%(62/217).Conclusions:(1)The transrectal ultrasound guided 12-cores prostate biopsy and extended 12-cores prostate biopsy are safe methods and beneficial to diagnosis and differentiation of prostatic diseases. (2) Extended 12-cores prostate biopsy compared with 12-cores prostate biopsy can improve the cancer detection rates, increase of biopsy cores is more significant for patients and do not increase the incidence of complications.(3) Control blood glucose levels in diabetic patients before transrectal ultrasound guided biopsies, does not increase puncture complications.(4) PSA as indicator of the diagnosis of prostate cancer with high sensitivity and low specificity. Prostate biopsy positive rate is low when tPSA between 4-10 ng/ml, there is an obvious excessive operation. When PSA between 4.0-20.0 ng/ml PSAD can improve the effectiveness of the diagnosis of prostate cancer, reduce unnecessary prostate biopsy. |
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