Predictive Factors Of Prostate Cancer At Repeat Biopsy In Patients With High Serum Prostate-Specific Antigen

Objective: We discussed the predictive factors of prostate cancer at repeat biopsy inpatients with elevated serum PSA after initially negative biopsy.Methods: From July2001to October2011, A total of186men with suspectedprostate cance（rPSA＞4ng/ml and abnormal in MRI or transcrectal ultrasound guidedexamination）underwent prostate biopsy.All of them were diagnosed with negativeresults and received the second biopsy. They were divided into a prostate cancergroup and a noncancer group according to the final pathological diagnosis.Thedatabase of rebiopsied patients included initial prostate-specific antigen (PSA), PSAdensity (PSAD), total prostate volume (TPV), transitional zone volume of the prostate(TZV)，the initially pathological results，digital rectal examination. We analyzeddifferences in the aforementioned parameters between the2groups.Results: Diagnoses of prostate cancer were confirmed in20patients,166caces werediagnosed with benign results （Include benign prostatic hyperplasia, chronicprostatitis, intraepithelial neoplasm,and atypical small acinar proliferation weredetected）.Univariate analysis showed that AGE(P=0.785), PSA（P=0.125），PSAD(P=0.038), TPV(P=0.572) and TZV (P=0.033) between the cancer and noncancergroups, HGPIN（P=0.017）,ASAP（P=0.081），digital rectal examination（P=0.466）.the multivariate analysis showed that PSAD(P=0.036) and TZV(P=0.033) had astatistically significant correlation with cancer detection. Conclusion: PSAD andTZV are predictive factors of prostate cancer in patients with an initial negativebiopsy of high prostate-specific antigen levels. Early repeat biopsy is especiallyrecommended in cases with high parameters which is mentioned above.