The clinical study of transrectal ultrasound guided biopsies of the prostate cancer with PSA level less than 4 μg/L / 中华超声影像学杂志

ABSTRACT

Objective To evaluate the clinical value of transrectal ultrasound(TRUS)guided biopsies of the prostate cancer(PCA)with serum prostate specific antigen(PSA)level less than 4 μg/L.Methods Fifty-nine patients suspected PCA were underwent TRUS guided-biopsy.The ultrasonographic features of lesions and prostate gland were observed.The PSA,PSA density(PSAD),F/T(free/total PSA ratio),prostatic volume(PV)were compared between PCA group and non-PCA group,and further analyzed the sensitivity and specificity of PSAD and F/T at different thresholds for PCA diagnosis.Results In 59 patients,16 were proved to be cancer by pathological examination,the positive detection rate was 27%.In these 16 patients,12 had lesions on ultrasound,which locatqed in outer gland.The rich vascularity was observed in PCA more than in benign and precancerous lesion.There were statistical significant differences in PSA,PSAD,F/T,PV between PCA and non-PCA groups.When selecting threshold of PSAD and F/T were 0.09 and 0.20,respectively,there were the highest diagnostic specificity and sensitivity.The diagnostic specificity and sensitivity of PSAD were higher than those of F/T.Conclusions TRUS guided biopsies of the prostate is one of the most efficient methods for detection of PCA with PSA level less than 4μg/L.Combining TRUS features with PSA parameters can further increase positive detection rate of PCA.