The Role Of PSA Related Parameters In Prostate Biopsy Strategies

Purpose: In present study,we evaluated the diagnostic efficacy of different parameters related to prostate specific antigen for prostate cancer and the difference of two type prostate biopsy strategies based on PSA related parameters.Methods: We retrospectively analyzed the data of patients who received prostate biopsy from March 2013 to and September 2018 in our hospital.The diagnostic efficacy of serum total prostate specific antigen,prostate specific antigen density,free PSA ratio to total PSA,transitional zone prostate specific antigen density and compound prostate specific antigen density for prostate cancer were compared by the receiver operating characteristic curve.Accorded to different parameter levels,the results of ultrasound and digital rectal examination,the cancer detection rate of two biopsy strategies was compared.In addition,this study also combined the results of biopsy pathology to evaluate the difference of high-score tumor detection rate between the two groups.Results: ROC curve showed prostate specific antigen density of the transitional zone was the valuable parameter for detect prostate cancer.12+X cores biopsy could find more positive cores in the patients with tPSA?10ng/ml and prostate volume ?60ml.similar results was found prostate specific antigendensity?0.15ng/ml·cc-1 and negative transrectal ultrasound result.Used 12+x cores biopsy also can detected more prostate cancer when free prostate specific antigen /total prostate specific antigen value greater 0.15 with PSAD?0.15ng/ml·cc-1.In addition,when prostate specific antigen less than 20ng/ml,if prostate volume less than 60 ml or free prostate specific antigen /total prostate specific antigen value more than 0.15,negative transrectal ultrasound result,using 12+x method biopsy can detect more Gleason score greater than 7 prostate cancer.Conclusions: TZPSAD were expected to be valuable parameters in the diagnosis of prostate cancer.For patients with prostate specific antigen density>0.15ng/ml cc-1 or free prostate specific antigen /total prostate specific antigen value value>0.15,12 + X method biopsy is recommended as an initial biopsy protocol.For patients with negative transrectal ultrasound result or Digital rectal examination results,they also recommended received 12 + X method biopsy.