Xin yixue (Feb 2024)

Comparative study of the values of transperineal and transrectal prostate puncture in diagnosis of prostate cancer in patients with gray/sub-gray zone of PSA

  • Wang Hailuo, Pang Kun, Wang Jingkai, Xu Peng, Xu Hao, Pan Deng, Ma Yuyang, Zhang Ruoran, Han Conghui

DOI
https://doi.org/10.3969/j.issn.0253-9802.2024.02.011
Journal volume & issue
Vol. 55, no. 2
pp. 132 – 137

Abstract

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Objective To compare the diagnostic values of transperineal and transrectal ultrasound-guided prostate puncture for prostate cancer in patients with gray / sub-gray zone of prostate-specific antigen （PSA）. Methods A total of 110 samples were collected from patients with PSA≤20 ng/mL who underwent transperineal and transrectal ultrasound-guided prostate puncture. All patients were divided into two groups according to different patterns of prostate puncture. The detection rates of prostate cancer and CsPCa of patients with PSA in the gray/ sub-gray zone were compared between two different puncture methods. Surgical conditions and degree of pain were compared between two groups，including operation time，bleeding，intra-operative and post-operative VAS pain scores. The incidence of complications was also compared between two groups，including pain，fever and hematuria，etc. The probability of complications was assessed in two groups. Results The detection rate of prostate cancer in the transperineal ultrasound-guided prostate puncture was higher than that in the transrectal prostate puncture （P<0.05）. Further subgroup analyses showed no statistical significance in the detection rates of prostate cancer in patients with PSA gray zone between two groups （P>0.05），but patients with PSA sub-gray zone in the transperineal ultrasound-guided prostate puncture group had a higher detection rate （P<0.05）. PSA sub-gray zone CsPCa in the PSA sub-gray zone accounted for a higher proportion of patients with positive puncture than that in the PSA gray zone （P<0.05）. There was no significant difference between two different puncture methods in terms of puncture time，bleeding，degree of pain and incidence of complications （all P>0.05）. Conclusions For patients with PSA gray zone，there is no significant difference in the detection rate of prostate cancer between two modalities. Nevertheless，for patients with PSA between 10-20 ng/mL sub-gray zone，transperineal ultrasound-guided prostate puncture yields better diagnostic and application value compared with transrectal ultrasound-guided prostate puncture.

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