Comparison Of The Relationship Between The Positive Rate Of Prostate Biopsy And Gleason Score In Different Serum PSA Levels

Objective:Comparison of the relationship between the positive rate of prostate biopsy and Gleason score in different serum PSA levels.Methods:Collect the clinical data of 122 patients with suspected prostate cancer from September 2014 to December 2015 at the China-Japanese Union Hospital of Jilin University,Age range 49-91 years,mean 71.2 ±5.6 years,All patients underwent rectal examination,serum PSA,rectal prostate ultrasound and other tests suggest prostate cancer,All patients underwent ultrasound-guided prostate biopsy,57 cases were treated with local infiltration of tetracaine mortar and 65 cases were injected with 5ml povidone.The VAS score was used to evaluate the improvement of pain.Puncture pathology results were diagnosed as prostate cancer patients in 55 cases,according to the different serum PSA values will be divided into four groups: group A(PSA <4ng / ml),group B(4ng / ml<PSA <10ng / ml),group C(10ng / ml <PSA <20ng / ml)and group D(PSA?20ng / ml).The positive rate of prostate puncture and the Gleason score were statistically compared between different serum PSA levels for prostate biopsy and Gleason scores,with serum PSA between 4-20 ng /ml with PSAD = 0.19 ng /(ml * Cm3)were divided into two groups,and the relationship between the positive rate of prostate puncture was compared between the two groups.Result:122 patients were successfully completed under the guidance of color Doppler ultrasound 10 needle system puncture.A total of 55 patients(45.1%)had prostate cancer,48 were benign prostatic hyperplasia,5 had prostatitis,12 had prostate intraepithelial neoplasms,1 had granulomatous prostatitis,and 1 had tuberculosis.Gleason score ? 7points in 22 cases(40.0%)Gleason score ? 8 points in 33 cases(60.0%).1.A group of 3 were due to the rectal color super-tips abnormal echo line prostate biopsy,diagnosed with prostate cancer in 1 case,Gleason score of 6 points.2.The positive rate of prostate cancer in B group(4ng / ml <PSA<10ng / ml),group C(10ng / ml <PSA <20ng / ml)and group D(PSA?20ng / ml)was 17.4% 23),31.7%(13/41),67.3%(37/55).There was no significant difference between group B and group C(p>0.05).There was significant difference between group B and group D(p<0.05),and the difference between group C and group D was statistically significant(p<0.05).3.B and C groups were divided into two groups with PSA density(PSAD)= 0.195 ng /(ml * cm3),the positive rate of prostate cancerpuncture in PSAD <0.19 ng /(ml * cm3)group and PSAD> 0.19 ng /(ml *cm3)group was 10.7%(3/28),38.9%(14/36),the positive rate of prostate biopsy between the two groups was statistically significant(p<0.05).4.Group B(4ng / ml <PSA <10ng / ml)patients with prostate cancer in 4 cases,the Gleason score ? 7 points,C group(10ng/ml<PSA<20ng/ml)and D group(PSA = 20ng/ml)Gleason score more than 8 points were respectively 38.5%(5/13),75.7%(28/37),there was no significant difference between B group and C group(p > 0.05),the difference between B group and D group was statistically significant(p<0.05),the difference between C group and D group was statistically significant(p<0.05).5.The postoperative VAS score of tetracaine mucilage group was2.109±0.685,and the VAS score of the control group was4.179±0.851,and the difference was statistically significant(P < 0.05).Conclusion:1.the positive rate of prostate cancer,Gleason score and serum PSA were positively correlated.With the increase of serum PSA value,the positive rate of prostate puncture was increased,and the Gleason score increased.2.When PSA is located in 4-20ng/ml,With PSAD = 0.19 ng /(ml *cm3)as the critical value can improve the positive rate of prostate cancer.3.Local anesthesia with tetracaine mucilage can reduce the pain ofprostate biopsy,and it is a safe and effective method,which is worthy of popularization and application.