Analysis Of Relevant Risk Factors Affecting The Results Of The Prostate Puncture Biopsy Results Of The PSA Interval Of The Gray Area

Objective:By analyzing the patients in the PSA interval in the gray area,prostate puncture biopsy was performed,and the risk factors and detection rate of prostate cancer were diagnosed during the operation,which provided a theoretical basis for the following clinical diagnosis.Methods:The medical records of patients undergoing transrectal ultrasound-guided prostate biopsy in Jiangsu North Hospital Affiliated to Yangzhou University from January 2020 to February 2022 were retrospectively collected.According to the inclusion and exclusion criteria,a total of 221 patients were included in the study,including 148 patients with negative puncture results and 73 patients with prostate cancer.The detection rate was 33%.Through univariate and multivariate analysis of age,f/tPSA,prostate volume,PSAD and other parameters,to explore the independent risk factors of prostate cancer.The effectiveness of independent risk factors was tested by subject operating characteristic curve.Results:In univariate analysis of prostate cancer,there were significant differences in age(P=0.004),PSAD(P=0.000),f/tPSA(P=0.019),nuclear magnetic examination(P=0.000)and prostate volume(P=0.787)among prostate cancer patients(P<0.05).There were no significant differences in BMI(P=0.753),hypertension(P=0.000),diabetes(P=0.704),coronary heart disease(P=0.927),urine routine(P=0.566),hematuria(P=0.432),LUTS(P=0.0.879)and PSA(P=0.059)(P>0)05).After multivariate analysis,age(P=0.008),PSAD(P=0.038)and prostate MRI(P=0.000)had statistical significance(P<0.05),and were independent risk factors for prostate cancer.There were no significant differences in prostate volume(P=0.051)and f/tPSA(P=0.053).By means of ROC curve analysis,the area under the curve of parameters of age,PSAD,prostate magnetic,combined age and PSAD,combined age and prostate magnetic,combined PSAD and prostate magnetic,combined age,PSAD and prostate magnetic,0.653,0.804,and 0.709 were respectively 0.619,0.806,0.804,and 0.709.0.831,0.843.Age factor sensitivity was 0.644,specificity was 0.615,and Yoden value was 0.259.The sensitivity and specificity of PSAD factor were 0.753,0.764 and 0.517 respectively.The sensitivity,specificity and Yoden value of prostate were 0.699,0.608 and 0.307 respectively.The sensitivity of combined age and PSAD was 0.699,specificity was 0.811,and Yoden value was 0.510.The sensitivity and specificity were 0.699,0.655 and 0.354,respectively.The combined PSAD and prostate nuclear magnetic sensitivity was 0.849,specificity 0.709,Yoden value 0.558,combined age,PSAD and prostate nuclear magnetic sensitivity was 0.822,specificity 0.743,Yoden value 0.565.Conclusion:For PSA in grey area,systematic prostate puncture biopsy in patients with negative anal digital examination and rectal ultrasound examination showed that the independent risk factors for the diagnosis of prostate cancer were age,PSAD and prostate nuclear magnetic test,among which PSAD had higher diagnostic value.The combination of age,PSAD and prostate MRI can help to guide whether further prostate puncture biopsy is needed in clinic,reduce unnecessary puncture,and provide guidance for the future clinical application of prostate puncture biopsy.