scholarly journals Analysis of the spatial distribution and clinical features of prostate cancer in transperineal prostate biopsy

2019 ◽  
Author(s):  
Chen Jia-Jun ◽  
Zhu Zai-Sheng ◽  
Zhu Yi-Yi ◽  
Zhou Yi-Bo ◽  
Shi Hong-Qi

Abstract Background Recently, most studies on the spatial distribution of the prostate cancer are based on the samples confirmed by transrectal prostate biopsy (TRBx), which could distinguish the distribution of cancer lesions between the apex, middle and basal parts of the prostate, but the distinction between lesions in the left and right sides of prostate cancer and the transitional and peripheral bands remains to be considered. Further, there has been little research on the specific proportion of cancer in prostate biopsy tissue. The current study aimed to analyze the clinical characteristics, diagnostic efficacy of relevant indicators, and reveal the spatial distribution of prostate cancer in transperineal prostate biopsy (TPBx). Methods A total of 810 patients underwent TPUS-guided 10-core prostate biopsy in our hospital from Oct. 2016-to Feb. 2019, participants' clinical data and the diagnostic yield of the cores were recorded and retrospectively analyzed as a cross-sectional study. Results Age, total prostate specific antigen (t-PSA), prostate volume (PV), prostatic inflammation, dysuria, hematuria, asymptomatic and MRI were independent factors in prostate cancer (Pca) patients compared with non-Pca patients (P<0.05). The cut-off points for age, t-PSA, free prostate specific antigen (f-PSA), PSA density (PSAD), free/total prostate specific antigen (f/t PSA) and PV were 73years old, 15.43ng/ml, 4.545ng/ml, 0.475ng/ml*cm3, 0.123 and 41.45ml, respectively. The PRPN of left peripheral zone (LPZ) prostate tumor was elevated regardless of the Gleason score. However, the PRPN of left transitional zone (LTZ) was lower than LPZ and similar to right peripheral zone (RZ), but PRCF and CFVR were significantly higher, especially in tumors with higher Gleason score (≥8). Conclusions For Chinese, the t-PSA standard and the PSAD standard in the puncture indication should be increased, while the f/t PSA standard should be reduced. At the same time, multi-factor assessment is needed to determine whether patients need a prostate biopsy or not. The spatial distribution of prostate cancer is asymmetrical, with more cancer lesion on the left than on the right. The PRPN of LPZ is relatively higher. LTZ has higher PRCF, and most of them were large lesions with high Gleason score (≥8).

2004 ◽  
Vol 171 (1) ◽  
pp. 197-199 ◽  
Author(s):  
PAOLO EMILIOZZI ◽  
PAOLO SCARPONE ◽  
FRANCESCO DePAULA ◽  
MAURIZIO PIZZO ◽  
GIORGIO FEDERICO ◽  
...  

2020 ◽  
Author(s):  
Sat Prasad Nepal ◽  
Takehiko Nakasato ◽  
Yoshio Ogawa ◽  
Yoshihiro Nakagami ◽  
Takeshi Shichijo ◽  
...  

Abstract Background: Many patients undergo unwanted prostate biopsy due to unreliability of prostate-specific antigen (PSA). PSA density (PSAD), free PSA, free-to-total PSA ratio, prebiopsy MRI are used to diagnose prostate cancer (PCa). Since 1863, correlations between inflammation and cancer have been identified and explored; thus, the role of various blood parameters in detecting cancer has been studied, especially neutrophil-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio (PLR). Here, we evaluated whether these parameters before prostate biopsy can diagnose prostate cancer in our hospital.Methods: We conducted a retrospective study from January 2014 to January 2018. Prostate cancer patients were divided into significant cancer (Gleason Score ≥ 7) and insignificant cancer (Gleason Score < 7). NLR, PLR, and other clinical parameters were taken before the prostate biopsy. We then analyzed the associations of NLR and PLR alone or with PSA, with significant prostate cancer. Results: We included 463 patients, of whom 60.3% (279) had prostate cancer and 75.6 % (211) had a Gleason score (GS) of ≥ 7. PSA and PSAD in the clinically significant prostate cancer patient group were around two times more than those in the insignificant prostate cancer group. PV, NLR, PLR, and combined markers were more in the GS ≥ 7 population group. PSA combined with PLR (PPLR) and PSA with NLR (PNLR) had better area under a curve (AUC) (0.732 and 0.730, resp.), with statistical significance, than PSA, NLR, and PLR alone (0.723, 0.585, and 0.590). In the multivariate analysis using separate models with PSA and NLR or PLR compared to age, DRE-positive lesions, PV, PSAD; PNLR, and PPLR were statistically significant in finding aggressive prostate cancer. When combined markers were used together, despite the high correlations, PSA and NLR were nearly significant (p = 0.062) in detecting the GS ≥ 7 population.Conclusion: The combined use of PSA with PLR and PSA with NLR helps detect the differences between clinically significant and insignificant prostate cancer.


2019 ◽  
pp. 243-248
Author(s):  
PE Ngwu ◽  
GO Achor ◽  
VU Eziefule ◽  
JI Orji ◽  
FT Alozie

Background: Prostate Specific Antigen (PSA) is a commonly used marker in prostate cancer management. Gleason grading is one of the most powerful predictors of prostatic biological behaviour. PSA, when combined with the Gleason score and clinical stage, improves the prediction of the pathological stage for prostate cancer. Objectives: To assess the degree of correlation between PSA level and Gleason score as well as determine the likelihood of aggressiveness of prostate cancer using Gleason score as a parameter. Methods: A cross-sectional prospective study was conducted among 234 consecutive consenting patients presenting to the Urology Out-Patient Clinic between April 2015 and March 2018. Serum PSA was done and patients with values above 4ng/ml and/or abnormal Digital Rectal Examination (DRE) were selected to have a prostate biopsy. The sample was histologically analysed with Gleason score recorded for those with prostate cancer. Gleason score was then correlated with PSA levels. Results: The mean age for prostate cancer patients was 71.3±8.7 years. The mean PSA for patients with prostate cancer was 52.3±37.5ng/ml (Confidence Interval = 46.1-58.6) with p<0.001. About 18.2% of histologically confirmed prostate cancer cases had Gleason score 8-10 implying a high level of tumour aggressiveness. There is a positive correlation between PSA and Gleason score with R-value 0.590 indicating a good degree of correlation. Conclusion: There is a good degree of a positive correlation between PSA level and Gleason score, as well as a high level of aggressiveness of prostate cancer in Umuahia.


Author(s):  
Fatih Bicaklioglu ◽  
Hasan Aydin ◽  
Ahmet Özgür Güçtaş ◽  
Hamit Zafer Aksoy

Introduction Many men with non-clinically significant PCa (N-CSPCa) will not progress to become symptomatic within their lifetime. If we can predict clinically significant PCa (CSPCa), we can prevent patients from unnecessary biopsies, overdiagnoses, and overtreatment. The purpose of this study was to determine whether PSAD and f/t PSA can predict CSPCa (Gleason ≥ 7) in patients diagnosed with prostate cancer on biopsy with a PSA level of 2.5-10 ng/ml or not. Materials and Methods 78 patients who underwent TRUSG-guided prostate biopsy with PSA 2.5-10.0 in our clinic between March 2017 - August 2020 and whose pathology result was reported as prostate adenocarcinoma, were retrospectively evaluated. In addition to the demographic content of the patients, PSA, free PSA, prostate size (with TRUSG), rectal examination findings and prostate biopsy pathology results were recorded. Clinically significant prostate cancer was defined as a Gleason score 7. Results The mean age of the patients was 66.9 ± 8.4, PSA value was 6.9 ± 1.8, free / total PSA ratio was 18 ± 8.1%, and PSA density was 0.150 ± 0.078. The P values of PSA, free PSA, PSAD, f/t PSA, and prostate volume between CSPCa and N- CSPCa groups were 0.010, 0.780, 0.001, 0.084, and 0.030, respectively. The area under the ROC curve (AUC) of the PSAD for predicting CSPCa was 0.719 with a 95% Cl (0.604–0.835), and the standard errors were 0.062 and 0.059, respectively. When PSAD cutoff was 0.130 for predicting CSPCa, sensitivity and specificity were 75% and 63%, respectively. Conclusion PSAD can be used for predicting CSPCa, but f/t PSA can not. PSAD is not a strong stand-alone tool with its sensitivity and specificity, but we suggest that PSAD can be a part of future nomograms for predicting CSPCa and future protocols for active surveillance. Key words:prostate-specific antigen; clinically significant prostate cancer


2004 ◽  
Vol 45 (2) ◽  
pp. 160-165 ◽  
Author(s):  
Gunnar Aus ◽  
Charlotte Becker ◽  
Stefan Franzén ◽  
Hans Lilja ◽  
Pär Lodding ◽  
...  

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