| BackgroundWorldwide,the incidence of prostate cancer has always been at a high level,and the tumor has a certain differences in geographical and racial.The incidence rate of the foreign population of this disease is significantly higher than domestic,and this is one of the reasons why the research of the disease in foreign countries is ahead of ours.There are no obvious symptoms in the early stage,and notable clinical manifestations appear in the middle and late stage of prostate cancer.Additionally,lacking of the knowledge of this disease,medical awareness and poor environment and other reasons all have increased the difficulty in early diagnosis of prostate cancer among domestic people in general.The incidence of prostate cancer has boosted to be the highest in urinary tract tumors in our country since 2008,and this statistic is partly attribute to the more accurate diagnosis of prostate cancer.Prostate biopsy is the standard examination method for the diagnosis of prostate cancer and tumor grade,depth of invasion and tumor location.However,the key to make the optimal diagnosis and treatment of prostate cancer is how to get the feedback information of the therapeutic effect and guiding the next treatment for the patients in clinical work under the help of a variety of different imaging techniques and diversified treatment options.At present,there are two types of prostate biopsy,which are the transrectal and the transperineal biopsy.Laparoscopic radical prostatectomy is still one of the main treatments for prostate cancer.If prostate cancer patients accompanies with prostatitis,The pathological and physiological processes such as inflammatory cell infiltration will inevitably stimulate the glands,capsule and pelvic floor fascia to form local adhesion,not only increasing the difficulty of the operation,but also to ensure that the cut edge,postoperative overall survival rate of risk.ObjectiveCompare and analyze the IL-6 and IL-10 levels of expressed prostatic secretions before and after prostate biopsy between different groups,and make a comparison of the distribution of cancer,the inflammation of adjacent tissue,and the situation of cutting edge after radical operation from the perspective of tissue morphology.Analysis the correlation between biochemical recurrence time and the factors above.Whereas,the value of inflammatory factors IL-6,IL-10 and pathological changes after radical operation are also discussed in option of method of prostate biopsy and the treatment of prostate cancer.MethodsCollected patients of prostate cancer in Henan nationality that were carried out prostate biopsy in Henan Provincal Hospital from January 1st 2013 to 1st 2016.A total of 66 cases with 33 cases using transrectal method and 33 cases using transperineal method.The ages were 69.53±5.65 years old.TPSA were 1.80-98.60ng/ml,with a median of 28.24 ng/ml.The prostate volume was 15-63ml,the median is 27ml.Those patients were divided into two groups named TP and TR,in which TR group employing the transrectal ultrasound guided 10+X needles prostate biopsy transrectal preoperative;TP group applying the 11+X needles transperineal puncture biopsy of prostate preoperative.ELISA method was used to measure the level of IL-6 and IL-10 of EPS before and after the radical operation,and the normal group Control of 30 cases as a reference.The differences between the two groups were explained from the level of inflammatory cytokines.Correlation analysis between the level of IL-10 and IL-6 and clinical indexes showed that the correlation between inflammatory cytokines and clinical indexes.HE staining was performed on the pathology,pathology and adjacent tissues after the biopsy,and the difference of the two groups before and after biopsy and the inflammation of adjacent tissues were observed.The distribution characteristics and the cutting edge of the tissues after radical prostatectomy were compared with the pathological changes of prostate biopsy.Taking biochemical recurrence as the cut-off point,using Cox regression analysis to study the correlation between each index and postoperative biochemical recurrence,and to guide the clinical diagnosis and treatment.Results1.L6 level and IL-10 level of EPS before and after biopsy:Compared with the Control group,IL-6 and IL-10 levels were not significantly different between the TP and TR groups before biopsy,and the difference was not statistically significant(P>0.05);while the IL-6 and IL-10 in the TR group were significantly higher(P<0.05)after the biopsy,and the IL-6 was significantly higher in the TP group(P<0.05).Before and after compare:compared with the TP group before biopsy,the IL-6 and IL-10 in the TP group were not statistically significant after biopsy(P>0.05);compared with the TR group before biopsy,the IL-6 and IL-10 were both significantly increased in the TR group after biopsy(P<0.05).Parallel compare:compared with TP group,TR group and IL-6 IL-10 increased significantly after biopsy(P<0.05).2.There is a significant positive correlation between Gleason score and IL-6 level(P<0.05).There was a significant positive correlation between Gleason score and IL-10 level(P<0.05).Correlation coefficient was 0.387,which is moderate positive correlation.While the TPSA value is not significantly correlated with IL-6 and IL-10 levels(P>0.05).3.After curative surgery,the level of tissue morphology was confirmed:Tissue edema and inflammatory cell infiltration of TR group were more serious in prostate cancer tissues and adjacent tissues;the overall inflammatory condition was significantly stronger than that in the TP group.4.The positive rate was 27.27%(9/33).The positive rate was 3%(1/33)in the positive rate of the prostate apex of the 11+X needle in the rectum group.The difference was statistically significant between the two groups(P<0.05).TR group after radical surgery in general pathology at the tip,the front and the left side of the peripheral band and after the biopsy of the pathological changes was significantly different(P<0.05),I had no statistical significance.There was no significant difference between the TP group and group after radical operation in general pathology and preoperative area(P>0.05).5.The gross value of Cox survival test was statistically significant(P<0.01).Age,initial diagnosis TPSA,enveloped infiltration,Gleason score,preoperative IL-10 level and biopsy method had no significant effect on biochemical recurrence time(P>0.05).Although different biopsy methods were different in the time of BCR after radical operation,there was no statistical significance(P>0.05).And to cure the preoperative IL-6 level,precancerous tissue inflammation and pelvic lymph node metastasis and other factors on the biochemical recurrence time significantly(P<0.05),the pelvic lymph node metastasis have no effect on biochemical recurrence time was significant(P<0.01).The relative risk coefficient of IL-6 level before radical operation was 1.002.The relative risk coefficient of adjacent tissue inflammation was 2.449 while that for pelvic lymph node metastasis was 5.815.Conclusion1.The IL-6 levels of EPS and the adjacent tissue inflammation in the patients of prostate cancer before radical prostatectomy were valuable index of the BCR time as well as pelvic lymph node metastasis.2.The Gleason score was positively correlated with the IL-6 level of EPS in patients of prostate cancer before prostate biopsy.3.TRUS guided by transperineal 11+X needles biopsy of the prostate can provide comprehensive tumor information including anterior prostate tumors,and are consistent well with radical postoperative pathological results,which has certain guiding significance to the development of radical surgery,especially in ensuring the resection margins were negative when maximizing the retention of prostate apex,so as to facilitate the recovery of patients after the retention of normal urine control,improve the quality of life. |
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