Abstract：Objective: To explore the clinical significance of secondary prostate biopsy in metastatic castration-resistant prostate cancer (CRPC). Methods: 63 patients with CRPC in our hospital from July 2014 to July 2017 were randomly selected as the research subjects. All patients underwent secondary prostate biopsy. According to the secondary puncture results, the patients were divided into the combined intra-canal carcinoma (IDC-P) group (43 cases) and the unconsolidated IDC-P group (20 cases). The levels of prostate-specific antigen (PSA) and related parameters at the time of first puncture and second puncture were compared between the two groups. The follow up and prognosis of the patients were observed. Results: The first puncture results showed that 13 cases had IDC-P and 50 cases had normal adenocarcinoma. The second puncture results showed 43 cases had IDC-P and 20 cases had normal adenocarcinoma. The PSA, PSAD and PSATZ were (14.28 (+2.39) ng/mL, (0.26 (+0.41) ng/mL and (0.65 (+0.86) ng/mL respectively at the first puncture. At the second puncture, they were (17.32±2.73) ng/mL, (0.43±0.49) ng/mL, (0.99±1.01) ng/mL, respectively. The difference was statistically significant (t=70.968, 16.867, 17.991, P<0.05). The levels of PSA, PSAD, and PSATZ in the combined IDC-P group were (19.39±3.18) ng/mL, (0.57±0.52) ng/mL, and (1.27±1.03) ng/mL, respectively. Higher than the uncombined IDC-P group (15.26±2.59) ng/mL, (0.30±0.39) ng/mL, (0.71±0.81) ng/mL. The difference was statistically significant (t=5.072, 2.064, 2.140, P<0.05). At the mean follow-up (23.65±4.52) months, 11 patients died, and 52 patients (34 patients with IDC-P combined) received chemotherapy after the diagnosis of CRPC. There were 7 patients (20.59%) who had treatment responders in patients with IDC-P and 12 patients (66.67%) who had not responded to IDC-P. The difference between the two groups was statistically significant (χ2=10.777, P<0.05). Conclusion: The second biopsy is beneficial to the clinical understanding of the changes of metastatic prostate cancer (IDC-P) in a timely manner and has important guiding value for the treatment and prognosis of CRPC.
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2018, Vol. 24 
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