The Comparison Of Positive Rate Of Prostate Biopsy In Different PSA Interval

Objective:Compare positive rate of prostate biopsy in different PSA interval, explore the relationship between the PSA value and prediction of prostate cancer, and the relationship between the PSA value and the Gleason scores, and the relationship between the PSA value and the clinical stage. Provide reference for the early diagnosis of the prostate cancer. Methods:A retrospective analysis was made in 107 patients with ascending PSA who underwent prostate biopsy in our center. These 107 patients are divided into 4 groups according to different interval of PSA4<ng/ml, 4ng/ml<PSA<10ng/ml, 10ng/ml≤PSA≤20ng/ml, more than 20ng/ml to compare the correlation between the PSA value and biopsy positive rate, clinical stage, and the Gleason scores. 107 patients all went 10-12 needle based systemic prostate biopsy, 48 patients were diagnosed as prostate cancer, in group A 1 case, in group B 2 cases, in group C 9 cases, in group D 36 cases. Comparing the relationship between the PSA value and the positive rate, analyzing the correlation between the PSA value and Gleason scores and clinical staging. Results:Through the ultrasound guided trans-rectal core biopsies of the prostate, 48 cases of patients in 107 patients(44.9%) are pathologically confirmed as prostate cancer, the positive rate of different PSA interval are shown in table 1. The positive rate of Group B is 12.5%(2/16), the positive rate of Group C is 25%(9/36), the positive rate of Group D is 67.9%(36/53). With the increase of the PSA value, comes the increase of the positive rate of prostate biopsy. 10ng/ml≤PSA≤20ng/mlvs4ng/ml<PSA < 10ng/ml(X2 =1.038, P=0.308);PSA > 20ng/ mlvs10ng/ ml≤PSA≤20ng/ml(X2 =17.929, P=0.000);PSA > 20ng/mlvs4ng/ml <PSA<10ng/ml(X2 =15.258 P=0.000). There are only two cases in group A, one of them has been pathologically conformed as prostate cancer. At the same time, by comparing the relationship between the PSA value and Gleason scores, we found that the higher the PSA value is, the higher the Gleason scores are. Conclusion:The positive rate of ultrasound guided trans rectal prostate biopsy is positively related with the PSA value. With the increase of the PSA value, the patients have higher Gleason scores. This result indicates that patients with the higher PSA value, have the higher pathological stage and clinical stage.PSA cannot be token as the only measure to detect prostate cancer, we should pay attention to physical examination like DRE or accessory examination like TRUS.