Characteristics of prostate cancer detection rate (PCDR) in Chinese Han population under different prostate biopsy methods

Abstract

We analyzed the improvement of prostate cancer detection rate (PCDR) in Chinese Han population and summarized the characteristics of prostate cancer (PCa) with the advancement of prostate biopsy technologies. From March 1999 to March 2015, 3762 patients underwent the systematic 6-, 8- or 13-core biopsy, guided by finger or transrectal ultrasound (TRUS) at our center. The PCDR under different PSA intervals and different biopsy methods were analyzed. The trends of PSA level, age and Gleason score of PCa patients were summarized. The PCDR of finger-guided 6- and 8-core biopsies were 30.8% (340/1103) and 36.7% (147/401) respectively. In 2258 patients with TRUS-guided 13-core biopsies, 992 (43.9%) were diagnosed as PCa, higher than that with finger-guided biopsies (43.9% vs. 32.4%, p < 0.001). The PCDR of prostate peripheral zone was higher than that of medial zone (37.5% vs. 31.4%, p < 0.001). Interestingly, the PCDR of extra 13th core was higher than the mean positive rate of other 12 cores (70.7% vs. 56.0%, p < 0.001). The systematic 13-core prostate biopsy guided by TRUS is safe, effective, and economic for PCa diagnosis in developing countries like China. The extra 13th core biopsy is beneficial to increase the PCDR.

Big Medical Data Decision-Making Intelligent System Exploiting Fuzzy Inference Logic for Prostate Cancer in Developing Countries

“…Therefore, as shown in Fig. 1, in the first phase of machine-assisted system, six different disease indicators (tumor markers) could be adopted to evaluate the clinical stage of prostate cancer: Prostatic Acid Phosphatase (PAP), Prostate Membrane Antigen (PSMA), Total Prostate-Specific Antigen (TPSA), Free Prostate-Specific Antigen (FPSA), Hemoglobin (Hb), and Red Blood Cell (RBC) [8]. Since each disease indicator plays a different role in the diagnosis of prostate cancer, the data associate with disease indicators are reasonably divided into two categories: Key Parameters (KP) and General Parameters (GP).…”

“…Moreover, these healthcare personnel also must deal with hundreds of pathological reports from remote areas with behindhand medical system, because advanced medical devices and excellent physicians are centralized in big cities and first-class hospitals. What's more crucial is that heavy work and mental stress have already constituted a huge burden to those physicians, while thousands of patients are still waiting for malignant tumor diagnosis [7], [8]. Proportionately, in China, over 5000 patients must share one physician, and one general practitioner needs to take care of at least 70 prostate cancer patients a day [9], [10].…”

Relationship of Prostate Specific Antigen and its Derivatives with the Results of Prostate Biopsy

“…Çeşitli çalışmalarda prostat biyopsisi yapılan hastalarda kanser saptanma oranı %14,6-69,77 arasında değişmektedir. [23][24][25][26] Yaptığımız çalışmada, kanser saptanma oranı %34,5 olarak bulunmuştur. PSA hâlen; prostat kanserinde taramada, tanıda, evrelemede ve tedavi sonrası izlemde yaygın olarak kullanılan bir beliteçtir.…”

“…29 Pan ve ark., PSA 4 ng/mL altında kanser saptanma oranını %13,7, 4-10 ng/mL arasında %21,4 ve 10-20 ng/mL arasında ise 30,2 olarak bulmuşlardır. 26 Lee ve ark. ise kanser saptanma oranlarını PSA seviyesi 0-4, 4-10 ve 10-20 ng/mL için sırasıyla; %9,5, %20,9, %38,4 olarak bulmuşlardır.…”

“…40 Pan ve ark.nın yapmış olduğu bir çalışmada, DRM şüphesi olan hastaların %57,6'sında prostat kanseri saptanmış olup, DRM şüphesi olmayanlarda ise bu oran %25 olarak bulunmuştur. 26 Patil ve ark.nın yapmış olduğu diğer bir çalışmada, DRM şüphesi olanlarda kanser çıkma oranı %62,3 iken, DRM şüphesi olmayanlarda bu oran %24,6 olarak saptanmıştır. Bu çalışmada, DRM şüphesi olanlar için PPD %71,67 olarak bulunmuştur.…”