Tao Tao, Xia Kai-Guo, Shen De-Yun, Ge Qing-Yu, Li Bin, Xiao Jun, Xuan Qiang
Department of Urology, The First Hospital of the University of Science and Technology of China / Anhui Provincial Hospital, Hefei, Anhui 230001, China.
Zhonghua Nan Ke Xue. 2020 May;26(5):409-413.
To investigate the factors influencing the positive rate of prostate biopsy and its relationship with the prostate volume and inflammatory cell infiltration (ICI).
We retrospectively analyzed the clinical data on 230 cases of double-plane transrectal ultrasound-guided prostate biopsy in our Department of Urology, including the patients' age, body mass index (BMI), serum total prostate-specific antigen (tPSA), PSA density (PSAD), prostate volume, and ICI in the prostate tissue. We also investigated the relationship of the above factors with the pathological results of prostate biopsy by binary logistic regression analysis.
The positive rate of prostate biopsy was 38.7% (89/230) in the total number of cases, 28.57% (n = 56) in the 196 cases with tPSA < 100 μg/L, and 97.06% (n = 33) in the 34 cases with tPSA ≥ 100 μg/L. Binary logistic regression analysis showed that the positive rate of prostate biopsy in those with tPSA < 100 μg/L was correlated positively with age (P < 0.01, OR = 1.09), tPSA (P < 0.01, OR = 1.04) and PSAD (P < 0.01, OR = 10.04), negatively with the prostate volume (P < 0.01, OR = 0.98) and ICI (P < 0.01, OR = 0.22), but not with BMI (P > 0.05). As a predictor of positive prostate biopsy, tPSA > 10 μg/L exhibited a sensitivity of 82.14% and a specificity of 35.71%, while PSAD > 0.26 showed a sensitivity of 78.57% and a specificity of 71.43%.
Non-specific elevation of the tPSA level induced by increased prostate volume and inflammatory cell infiltration may lead to unnecessary biopsies in some patients. As a predictor of positive prostate biopsy, PSAD > 0.26 has a higher clinical application value than tPSA > 10 μg/L.
探讨影响前列腺穿刺活检阳性率的因素及其与前列腺体积和炎性细胞浸润（ICI）的关系。
回顾性分析我院泌尿外科230例双平面经直肠超声引导下前列腺穿刺活检的临床资料，包括患者年龄、体重指数（BMI）、血清总前列腺特异性抗原（tPSA）、PSA密度（PSAD）、前列腺体积以及前列腺组织中的ICI。通过二元逻辑回归分析研究上述因素与前列腺穿刺活检病理结果的关系。
前列腺穿刺活检总阳性率为38.7%（89/230），tPSA<100μg/L的196例患者中阳性率为28.57%（n=56），tPSA≥100μg/L的34例患者中阳性率为97.06%（n=33）。二元逻辑回归分析显示，tPSA<100μg/L患者的前列腺穿刺活检阳性率与年龄呈正相关（P<0.01，OR=1.09）、与tPSA呈正相关（P<0.01，OR=1.04）、与PSAD呈正相关（P<0.01，OR=10.04），与前列腺体积呈负相关（P<0.01，OR=0.98）、与ICI呈负相关（P<0.01，OR=0.22），与BMI无关（P>0.05）。作为前列腺穿刺活检阳性的预测指标，tPSA>10μg/L的敏感度为82.14%，特异度为35.71%，而PSAD>0.26的敏感度为78.57%，特异度为71.43%。
前列腺体积增大和炎性细胞浸润引起的tPSA水平非特异性升高可能导致部分患者进行不必要的活检。作为前列腺穿刺活检阳性的预测指标，PSAD>0.26比tPSA>10μg/L具有更高的临床应用价值。
