Analysis Of Positive Factors In Prostate Biopsy

Objective:To study the correlation between biopsy method,patient age,PSA,DRE,imaging examination and the positive rate of prostate biopsy,so as to improve the clinical diagnosis efficiency.Methods:A total of 860 patients with prostate biopsy received in Qilu Hospital of Shandong University from 2019-01-01 to 2021-12-31 were reviewed.Basic information,biopsy method,serum PSA,prostate volume,DRE,MRI and other data were collected.Patients were divided into transperineal group and transrectal group according to biopsy method.Patients were divided into 5 groups according to age:≤50 years old,51-60 years old,61-70 years old,71-80 years old and>80 years old.According to serum tPSA level,patients were divided into 6 groups:0～4ng/ml,4～10ng/ml,10～20ng/ml,20-50ng/ml,50～100ng/ml,>100ng/ml.According to prostate volume,patients were divided into 6 groups:<20ml,20-40ml,40-60ml,60-80ml,80-100ml and>100ml.The relationship between prostate biopsy method,patient age,PSA level,prostate volume,DRE,MRI and other factors and the positive rate of prostate biopsy was analyzed.And the gray zone of tPSA was further studied.Results:In this study,430 of 860 patients were diagnosed with prostate cancer,with an overall positive rate of 50.00%.There was no significant difference in the positive rate of biopsy between the perineal approach and the transrectal approach in the sample population and at different PSA levels(P>0.05).The positive rate of prostate biopsy increased with the age of patients(P<0.001).With the increase of serum tPSA level,the positive rate of biopsy and the proportion of high-grade prostate cancer increased(P<0.001).The positive rate decreased with the increase of prostate volume(P<0.001).When tPSA>4ng/ml,tPSA>10ng/ml,tPSA>20ng/ml,DRE and MRI were used as the diagnostic criteria,the sensitivities were 99.30%、89.53%、71.86%、54.47%and 92.86%,respectively.The specificity was 5.58%、47.44%、83.95%、91.69%、78.79%,and the accuracy was 52.44%、68.49%、77.9%、73.26%、85.42%,respectively.Conclusion:The method of prostate biopsy had no effect on the result of prostate biopsy.Age,PSA,prostate volume,DRE and MRI can predict the positive result of prostate biopsy.PSA diagnosis of prostate cancer is characterized by high sensitivity and low specificity.DRE has low sensitivity but high specificity in the diagnosis of prostate cancer.MRI has high sensitivity and specificity in diagnosis of prostate cancer.For patients who their tPSA in gray zone,it is suggested to establish a statistical model to improve the diagnostic efficiency of PCa.