Objective: To investigate the risk factors for clinically significant PCa diagnosed by transrectal ultrasound-guided systematic prostate biopsy in patients with MRI-negative and PSA-abnormal findings.
Methods: From January 2014 to December 2017, 335 male patients with MRI-negative (PI-RADS 2.0 score ≤ 2) and PSA-abnormal (4－30 ng/ml ) findings underwent systematic prostate biopsy guided by transrectal ultrasound under local anesthesia in our department. We collected and analyzed the demographic data, clinical symptoms, complications, past history and PSA density (PSAD) of the patients.
Results: Clinically significant PCa was diagnosed in 21 (6.3%) of the 335 patients. Multivariate logistic regression analysis showed that the independent risk factors were higher age (AUC: 0.704, P < 0.01) and PSAD (AUC: 0.743, P < 0.01). The cutoff values of age and PSAD were 71 years and 0.18 ng/ml/ml, respectively.
Conclusions: Higher age and PSAD are risk factors for clinically significant PCa. Prostate biopsy, even repeated or saturated puncture, is recommended for those aged >71 years old or with PSAD >0.18 ng/ml/ml so as to avoid missed diagnosis and unnecessary invasive biopsy as well. /.
Keywords: age; clinical significance prostate cancer; digital rectal examination; prostate-specific antigen; prostate-specific antigen density.