| Objective:The positive rate of 6,8,10 needle biopsy under the guidance of transrectal ultrasound was compared,and the correlation between alpha Methoyl coenzyme A-racemes(P504s),high molecular weight keratin(CKh),p63 protein,S-100 protein,and the correlation between ABO blood group antigen and prostate cancer were analyzed,discuss the diagnostic value and clinical significance of optimized puncture and immune indexes and blood groups in improving prostate cancer.Methods:1.A retrospective analysis of 238 cases of prostate cancer in our hospital from January 2011 to December 2014 were performed by ultrasound guided prostate biopsy.There were 69 cases of 6 needle puncture patients,98 cases of 8 needle puncture and 71 cases with 10 needle puncture.The positive rate of each group was compared with age,prostate volume and PSA level.2.Detect the expression of P504 s,CK-h,p63 and S-100 in cancer tissues with immunohistochemical method,analyze the correlation between the expression of these proteins,ABO blood group and the diagnosis of prostate cancer.3.Analyze the relationship between p63 and S-100 expression and prognosis of prostate cancer patients based on TCGA database.Result:1.Of the 238 cases,82 were prostate cancer,156 were non prostate cancer,and the positive rate was 34.45%.Among them,the positive rate of 6 needle group was 24.64%,the positive rate of 8 needle group was 38.78%,and the positive rate of 10 needle group was 38.57%.In 156 cases of non prostate cancer,there were 115 cases of prostate hyperplasia,21 cases of prostatitis,19 cases of intraepithelial neoplasia,and 1 case of chronic nonspecific granulomatous inflammation.2.when the prostate volume(PV)was equal or more than 30 mL,the positive rate of the 6 needle group,the 8 needle group and the 10 needle group were 13.73%,33.33% and 37.10% respectively.The positive rate of the 8 needle group was significantly higher than that of the 6 needle group.The positive rate of the 10 needle group was significantly higher than that in the 6 needle group,the difference was statistically significant(P<0.05).When the prostate volume(PV)<30 mL,the positive rates of the 6 needle group,the 8 needle group and the 10 needle group were 50%,60% and55.56%,respectively.There was no significant difference in the positive rate of each group(P>0.05).3.when the age was equal or more than 70 years old,the positive rate of 6needle group,8 needle group and 10 needle group were 30%,41.94% and51.16% respectively.The positive rate of puncture in 10 needle group was significantly higher than that of 6 needles group,the difference wasstatistically significant(P<0.05).When the age was <70 years old,the positive rates of the 6 needle group,the 8 needle group and the 10 needle group were 10.53%,33.33% and 21.43%,respectively.There was no significant difference in the positive rate among the groups(P>0.05).4.when the PSA level was more than 10 ng/ mL,the positive rate of the 6needle group,the 8 needle group and the 10 needle group were 30.43%,45.45% and 51.16% respectively.The positive rate of the puncture in the 10 needle group was significantly higher than the 6 needle group,and the difference was statistically significant(P<0.05).When the level of PSA was between 4-10 ng/ mL,the positive rates of the 6 needle group,the 8 needle group and the 10 needle group were 12.50%,15% and 18.52% respectively.There was no statistical difference between the groups(P>0.05).5.The positive expression rate of P504 s in the cases of prostate cancer was96.34%,and the positive expression rate in non prostate cancer cases was12.18%.The positive expression rate of P504 s in the cases of prostate cancer was significantly higher than that in non cancer cases(P<0.05).The positive expression rates of p63 and CK-h in prostate cancer were both 3.66% and100% in non prostate cancer.The positive expression rates of p63 and CK-h in non cancer were significantly higher than those in prostate cancer,and the difference was statistically significant(P<0.05).There were only 5 cases of S-100,and the positive rate of prostate cancer was 80%.P504 s was a marker of prostate cancer,sensitivity was 96.34%,specificity was 87.92%,p63 andCK-h were positive express in non prostate cancer cases.6.The high expression of p63 is a protective factor for the survival of non biochemical recurrence after the operation of prostate cancer and the high expression of S-100 is a protective factor for the disease free survival after the operation of prostate cancer by analysising the TCGA database.p63 and S-100 can be used as an independent factor to predict the survival period after the operation of prostate cancer.7.There was no significant difference in ABO blood group distribution between prostate cancer patients and control group(P > 0.05).The results of this study did not show that ABO blood group antigen was significantly associated with prostate cancer.Conclusion:1.When the prostate volume is more than 30 mL,the age of the patient is more than 70 years old,and the PSA level is more than 10ng/mL,higher number of puncture needles can achieve higher positive diagnostic rate.When the prostate volume is greater than or equal to 30 mL,the 8 needle or 10 needle method should be adopted.When the age is more than 70 years old and the PSA level is above 10ng/mL,the 10 needle method is the best.When the prostate volume was less than 30 mL,age was less than 70 years old and PSA level was 4-10 ng/mL,there was no significant difference in the positive rate of different needle numbers.2.P504 s can be used as a high sensitivity and specificity marker for prostatecancer.p63 and CK-h can be applied to the differential diagnosis between non prostate cancer and prostate cancer.Analysis of the TCGA database shows that high expression of p63 and S-100 is a protective factor for prostate cancer and can be used as an independent prognostic indicator for prostate cancer.Further combine detection of the above immune indicators,complementary and reasonable judgement is conducive to early diagnosis of prostate cancer and improving the diagnostic accuracy of prostate cancer.3.The results of this study do not yet indicate that ABO blood group is significantly associated with prostate cancer. |
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