The Diagnostic Value Of Testosterone Level Combined With PI-RADS Score In Patients With PSA 4-10ng/ml

Purpose To explore the diagnostic value of prostate biopsy for patients with prostate-specific antigen(PSA)between 4 and 10ng/ml by the combined detection of testosterone(T)level and pi-rads score.Materials and Methods A retrospective analysis was performed on 125 patients who underwent transrectal ultrasound-guided prostatic puncture(TRUS)after the completion of routine hormone testing and magnetic resonance imaging(mri)after the PSA between 4-10ng/ml admitted to the department of urology of the first affiliated hospital of fujian medical university from January 2018 to January2020.According to the postoperative pathological results,the patients were divided into prostate cancer group and non-prostate cancer group,and the differences of relevant clinical data between the two groups were compared by single factor analysis.And whether there are differences in the indicators of prostate cancer with clinically significant prostate cancer(cs PCa)and without clinically significant prostate cancer(Ins PCa)in the prostate cancer group.To explore the diagnostic value of testosterone level combined with pi-rads score in psa4-10 ng/ml patients.Results In this study,a total of 125 patients with PSA"grey area"underwent prostate puncture were included.Postoperative pathological results showed that 29patients had prostate cancer(23.2%)and 96 patients had non-prostate cancer(76.8%).Prostate volume(P=0.003),testosterone level(P=0.018),PSAD(P<0.001),and pi-rads v2 score(P<0.001)were statistically different between the two groups.Further Logistic multivariate analysis showed that there were statistically significant differences in prostate volume(P=0.035),testosterone level(P=0.044),PSAD(P=0.021)and pi-rads v2 score(P<0.001)between the two groups.There were no significant differences in age,prostate volume,testosterone levels,PSAD and pi-rads v2 scores between clinically significant prostate cancer and non-clinically significant prostate cancer in the prostate cancer group.ROC curve was plotted by Medcalc software,and AUC(area under the curve)was calculated.The area under the curve predicted by age,prostate volume,testosterone level,PSAD and pi-rads v2 scores were 0.610,0.696,0.635,0.700 and 0.812,respectively.The optimal cut-off points were>64 years old,≤40.84 cm~3,≤18.25nmol/L,and>,respectively.0.21 ng/ml/cm~3and>Three points.The sensitivity and specificity of prostate cancer prediction were 89.66%/34.38%,48.28%/84.37%,68.97%/54.17%,41.38%/92.71%,and 79.31%/78.12%,respectively,at their respective optimal cut-off points.The predictive value of each parameter in the diagnosis of prostate cancer was further compared.It was found that the ROC curves of prostate volume vs.testosterone level,prostate volume vs.PSAD,testosterone vs.PSAD,and PSAD vs.pi-rads v2 scores in the same group showed no significant statistical difference,indicating that the predictive value of prostate cancer in the same group was similar between the two.Compared with pi-rads v2score and testosterone pi-rads v2 score,the predictive value of pi-rads v2 score for prostate cancer in the two groups was higher than that of prostate volume(P=0.033)and testosterone(P=0.010).Furthermore,the parameters were combined in pairs to evaluate the predictive value of combined diagnosis for prostate cancer.The AUC of prostate volume combined with testosterone level,prostate volume combined with PSAD,prostate volume combined with pi-rads v2 score,testosterone combined with PSAD,testosterone combined with pi-rads v2 score,and PSAD combined with pi-rads v2 score were 0.741,0.708,0.841,0.749,0.830,and 0.843,respectively.All the combined detection methods had clinical significance.The sensitivity and specificity of the combined diagnosis for the diagnosis of prostate cancer were 72.41/68.75%,41.38/91.67%,79.31%/82.29%,68.97%/76.04%,79.31%/79.17%,and 79.31%/81.25%,respectively,at the optimal cut-off points of each group.Further comparing the two separate parameter combination of 6 kinds of joint detection index,predictive value of diagnosis of prostate cancer,and prostate volume-PSAD joint inspection group effectiveness is better than that of prostate volume-testosterone joint detection group(P=0.028),PSAD-PI-RADS v2 score joint inspection group effectiveness is better than that of prostate volume-testosterone joint detection group(P=0039),testosterone-PI-RADS v2score joint inspection group effectiveness is better than that of prostate volume-PSAD joint inspection group(P=0.047),The detection efficiency of the psad-pi-rads v2 score combined detection group was better than that of the prostate volume-psad combined detection group(P=0.002),and the detection efficiency of the prostate volume-pi-rads v2 score combined detection group was better than that of the prostate volume-psad combined detection group(P=0.002).Conclusions At present,the indicators used to evaluate the risk of prostate cancer have some guiding significance.Among them,when testosterone,PSAD and pi-rads v2 scores were applied to predict,the accuracy was 63.5%,70.0%and81.2%,respectively.According to the findings of this study,the optimal combination of predictive value was the psad-pi-rads v2 score combined prediction group,followed by the combined prediction group of testosterone-pi-rads v2 score and the combined prediction group of prostate volume-PSAD.