The predictive efficacy of hypoechoic lesion in ultrasound for prostate cancer in Chinese people: five-year experience in a moderated 10-core transperineal prostate biopsy procedure

// Tian Yang 1, 3, * , Limin Zhang 2, 3, * , Yixin Chen 4, * , Yehua Cai 4 , Haowen Jiang 1, 3 and Qiang Ding 1, 3 1 Department of Urology, Huashan Hospital, Fudan University, Shanghai, China 2 Department of Urology, Huashan North Hospital, Fudan University, Shanghai, China 3 Fudan Institute of Urology, Huashan Hospital, Fudan University, Shanghai, China 4 Department of Ultrasonography, Huashan Hospital, Fudan University, Shanghai, China * These authors contributed equally to this work Correspondence to: Limin Zhang, email: alexzlm1126@126.com Haowen Jiang, email: urology_jhw@126.com Keywords: PSA, transperineal prostate biopsy, prostate cancer, transrectal ultrasound, hypoechoic lesion Received: February 07, 2017 Accepted: May 21, 2017 Published: June 02, 2017 ABSTRACT We aim to investigate the predictive efficacy of hypoechoic lesion for prostate cancer at different levels of serum PSA in the procedure of transrectal ultrasound guided 10-core trans-perineal prostate biopsy (TP-PBx). In this study, we collected clinical parameters involving age, digital rectal examination (DRE), PSA, prostate volume, pathological diagnosis, Gleason score, novel Gleason group, and numbers of positive cores from 856 patients who had elevated level of PSA above 4 ng/ml or susceptible nodule of prostate gland in DRE received the moderated 10-core TP-PBx procedure. There were 481 cases (56.2%) with no visible lesion of hypoechoic nodule in transrectal ultrasound (TRUS) and 375 cases (43.8%) with the hypoechoic lesion. The total cancer detection rate is 45.56%. The predictive efficacy of hypoechoic lesion for prostate cancer varies among different PSA intervals. For PSA groups of 0–4, 4–10, 10–20, 20–100, > 100 ng/ml, the Youden’s indexes are 0.3483, 0.3506, 0.3941, 0.2795 and 0.8667, respectively. Besides, the visible lesions are inclined to be detected in patients with higher Gleason score. We concluded that the hypoechoic lesions in TRUS could improve the predictive accuracy for diagnosing prostate cancer and present different predictive efficacy in the respective PSA intervals. Besides, it was probably associated with more aggressive clinical significance.