Risk Factors Analysis Of Prostate Cancer For Patients That First Prostate Biopsy With PI-RADS 1-3

Objective: In order to increase the positive rate of prostate biopsy in patients with low PI-RADS scores.We analyze the risk factors and the detection rate of prostate cancer with PI-RADS 1 to 3 in the first prostate biopsyMethods: Select the patients undergoing transrectal ultrasound-guided prostate biopsy in our hospital from January 2015 to December 2020,and limited PI-RADS scores of 1 to 3.Finally,239 patients were selected,175 patients with negative puncture results,64 patients with positive puncture results,the detection rate was26.8%.36 patients were diagnosed with clinically meaningful prostate cancer,the detection rate was 15.1%.12 parameters were included,including demographic data,comorbidities,clinical symptoms,and biochemical examinations.Single-factor and multi-factor analysis were used to find independent risk factors for prostate cancer.And through the receiver operating characteristic curve to test the efficacy of independent risk factors.Results: In the result of sigle-factor of prostate cancer,age(P<0.001),total PSA(P<0.001),PSA ratio(P=0.006),prostate volume(P<0.001),PSAD(P<0.001)all have Statistical significance.In the result of muti-factor analysis,it was confirmed that age(P<0.001)and PSAD(P<0.001)were independent risk factors for the diagnosis of prostate cancer.After ROC analysis,the AUC of the combined age and PSAD parameters was 0.795,the sensitivity was 75.0%,the specificity was 78.3%,and the negative predictive value was 0.895.In the result of sigle-factor of clinically significant prostate cancer,age(P<0.001),total PSA(P=0.001),PSA ratio(P=0.001),prostate volume(P<0.001),PSAD(P<0.001)have Statistical significance.In the result of muti-factor analysis,only age(P<0.001)and PSAD(P<0.001)were independent risk factors for clinically significant prostate cancer.After ROC analysis,the AUC of the combined age and PSAD parameters was 0.835,the sensitivity was91.7%,the specificity was 69.0%,and the negative predictive value was 0.979.And the best cut-off value of age is 69 years,and the best cut-off value of PSAD is0.27ng/ml/ml.Conclusion: When patients with PI-RADS≤3,there is still a certain proportion of patients diagnosed with prostate cancer or patients with clinically significant prostate cancer.We confirm combining age and PSAD can increase the detection ratio of the clinical significant prostate cancer.When the age is more than 69 years,and the PSAD is greater than 0.27ng/ml/ml,in patients with PI-RADS score ≤ 3 points,it is suggested to do prostate puncture.