Establishment of a nomogram for predicting positive repeat prostate biopsy in Chinese men / 中华男科学杂志

ABSTRACT

<p><b>OBJECTIVE</b>To develop a nomogram for predicting the probability of prostate cancer at transrectal ultrasound-guided repeat prostate biopsy in Chinese men.</p><p><b>METHODS</b>We performed repeat biopsy for 170 patients with benign prostate diseases diagnosed on the first biopsy, and analyzed the correlation of positive repeat biopsy with age, prostate volume, PSA, free-to-total PSA (f-PSA/t-PSA), PSA velocity, PSA density, results of digital rectal examination (DRE) and previous histology. We entered the variables stepwise into logistic regression models, and established a nomogram for the risk score on the probability of positive repeat biopsy, whose predictive value was assessed by receiver operating characteristic (ROC) analysis.</p><p><b>RESULTS</b>Prostate cancer was detected in 31.8% of the repeat biopsies (54/170). The most accurate predictive nomogram comprised age, PSA, f-PSA/t-PSA, PSA velocity, prostate volume, DRE and previous prostatic intraepithelial neoplasia (PIN) findings. The nomogram exhibited a high predictive value, with the area under the ROC curve (AUC) of 82.4%, significantly greater than that of the prediction based on PSA density (AUC 66.9%), prostate volume (AUC 72.6%), PSA velocity (AUC 69.6%), f-PSA/t-PSA (AUC 69.3%), or DRE (AUC 58.5% ) alone.</p><p><b>CONCLUSION</b>The nomogram is an accurate multi-variable predicting tool to determine the probability of positive repeat prostate biopsy.</p>