Relationship of prostate specific antigen related variables and MRI + MRS examination with prostate biopsy / 中华老年医学杂志

ABSTRACT

Objective To evaluate the relationship of prostate specific antigen(PSA)related variables and MRI+MRS examination with the results of prostate biopsy.Methods A total of 1227 patients aged(66.1± 7.7) years (range,55-90 years) undergoing prostate biopsy in our hospital from May 2014 to September 2018 were retrospectively analyzed.Two hundred forty-two patients with serum prostate-specific antigen (PSA)in "the grey zone (total PSA =4-10 μg/L)",and having indications for prostate biopsy were selected.According to the results of transrectal ultrasound-guided prostatic biopsy,patients were divided into the prostate cancer group and the benign prostate hyperplasia group.The levels of total PSA (tPSA),free PSA/tPSA ratios (f/t PSA),prostate specific antigen density(PSAD),(f/t) PSA/PSAD,prostate volume (PV) and other relevant data,as well as MRI+MRS test findings were statistically analyzed.Results The positive cancer rate of prostate biopsy was 26.0％ (63/242)in patients with total PSA in "the grey zone",including 56 cases of adenocarcinoma,3 cases of mucinous adenocarcinoma,and 4 cases of stromal sarcoma.Negative prostate biopsy results were found in 179 cases.Two hundred sixteen patients underwent MRI+MRS test before prostate biopsy,among which 81 were positive and 135 were negative.There were significant differences in PSAD,(f/t) PSA/PSAD,PV and MRI + MRS test findings (P =0.001,0.002,0.045 and 0.001)and there was no significant difference in tPSA and free/total PSA ratios(P＞0.05)between the prostate cancer group and the benign prostate hyperplasia group.Conclusions The positive cancer rate of prostate biopsy in patients with total PSA in the gray zone is 26.0％.The PSAD,(f/t)PSA/PSAD,prostate volume and MRI+ MRS examination are very useful for whether or not to perform the prostate biopsy,which can be used to guide the prostate biopsy in patients with total PSA in the "gray zone".