Application Value Of MRI And TRUS Joint Positioning Biopsy For Patients With PSA In The Gray Area Of In Diagnosis Of Prostate Cancer

Objective: Explore prostate MRI and Transrectal ultrasound(TRUS)joint positioning biopsy for patients with PSA in the gray area of in diagnosis of prostate cancer.Methods: In total,76 suspected for PCa patients with PSA in the gray area who are selected in the First Affiliated Hospital of Xinjiang Medical University urology from February 2015 to February 2017.All patients were treated with systematic 12 cores transrectal ultrasound-guided prostate biopsy.The multiparametric magnetic resonance imaging(mpMRI)is recommended prior to the prostate biopsy.Patients with suspicious lesions on mpMRI applied joint positioning biopsy.We compared pathologic results,including the rate of clinically significant prostate cancer cores(cancer length greater than5 mm and/or any Gleason grade greater than 3 in the biopsy core).Results: The mean PSA was 6.43 ng/mL.In total,48 of 76(63.2%)patients had abnormal lesions on mp-MRI,and 116 targeted biopsy cores,an average of 2.42 per patient,were taken.The overall detection rates of prostate cancer using MRI-TRUS joint positioning biopsy and TRUS systematic 12 cores biopsy were 47.9%(23/48)and 34.2%(26/76),respectively.In comparing the pathologic results of MRI-TRUS joint positioning biopsy and TRUS systematic 12 cores biopsy,the positive rates were 46.6 %(54/116)and 8.4 %(77/912),respectively(p<0.05).Mean cancer core lengths and mean cancer core percentages were 3.2mm and 24.5%,respectively,in systematic 12 cores biopsy and6.3mm and 45.4% in MRI-TRUS joint positioning biopsy(p<0.05).In addition,Gleason score ?7 was noted more frequently using MRI-TRUS joint positioning biopsy(p=0.028).The detection rate of clinically significant prostate cancer was 74.1%(40/54)and 35.1%(27/77)for MRI-TRUS joint positioning biopsy and systematic 12 cores biopsy,respectively(p<0.05).Conclusion: MRI-TRUS joint positioning biopsy showed betterperformance in the detection of clinically significant prostate cancer,compared to systematic 12 cores biopsy,among patients with PSA in the gray area.