【摘要】 目的:回顾性分析PSA<20 ng/mL患者前列腺穿刺阳性率的影响因素。方法:通过检索湖南省人民医院专病数据库，回顾性分析我院2019年04月至2023年04月行前列腺穿刺活检的患者资料，选取PSA<20 ng/mL病例，通过纳入排除标准后，将符合条件的67例作为本次研究对象。先采用单因素分析筛选出穿刺阳性影响因子，再将阳性因子采用多因素分析，最后绘制出ROC曲线效验本次研究目的。结果:纳入67例中Pca有35例(52.24%),非Pca有32例(47.76%)。进行单因素分析结果显示：Pca组与非Pca组在f/tPSA、PI-PADS、穿刺途径方面有显著性差异，fPSA、年龄、tPSA、PV、PSAD方面没有明显统计学差异。穿刺阳性病例中f/tPSA更小(54.29%vs 25.00%),PI-PADS评分更高(42.86%vs 0.00%),穿刺途径更趋向经会阴(48.57%vs 21.88%)。多因素分析显示f/tPSA、PI-PADS为穿刺结果的影响因素，将这2个影响因素及联合指标(f/tPSA、PI-PADS)进行ROC曲线分析，得出每个影响因素与联合指标对应穿刺结果的预测效果，结果显示f/tPSA的AUC为0.646,f/tPSA对于穿刺结果的诊断价值稍低(P<0.05),具有统计学意义；PI-PADS的AUC为0.731,PI-PADS对于穿刺结果的诊断价值较高(P<0.05),具有统计学意义；另外联合指标(f/tPSA、PI-PADS)的AUC为0.775,对于前列腺穿刺结果的诊断价值较高(P<0.05),具有明显统计学意义。结论:PSA<20 ng/mL的患者中PI-PADS评分、f/tPSA及PI-PADS联合f/tPSA是影响前列腺穿刺阳性率的重要影响因素。更多还原

【Abstract】 Objective:To analyze the factors influencing the positive rate of prostate biopsy in patients with PSA levels below 20 ng/mL.Methods:Data from patients who underwent prostate biopsy at Hunan Provincial People’s Hospital between April 2019 and April 2023 were retrospectively analyzed using the hospital’s specialized disease database.Patients with PSA levels below 20 ng/mL were included in the study.Initially, single-factor analysis was conducted to identify factors that positively influenced the biopsy results.Subsequently, multivariate analysis was performed to analyze the identified factors.Finally, a ROC curve was generated to validate the study’s objective.Results:Among the 67 patients, 35(52.24%)were diagnosed with prostate cancer, while 32(47.76%)were diagnosed with non-prostate cancer.Univariate analysis revealed significant differences in f/tPSA,PI-PADS score, and puncture approach between the prostate cancer and non-prostate cancer groups.However, no significant differences were observed in fPSA,age, tPSA,PV,and PSAD.In the positive biopsy group, f/tPSA levels were lower(54.29% vs 25.00%),PI-PADS scores were higher(42.86% vs 0.00%),and the transperineal puncture route was more frequently used(48.57% vs 21.88%).Multivariate analysis identified f/tPSA and PI-PADS as influencing factors for biopsy results.ROC curve analysis was performed for these factors and their combination(f/tPSA,PI-PADS) to determine their predictive value for biopsy results. The diagnostic value of f/t PSA for biopsy results was slightly lower (P <0. 05) but statistically significant. The AUC of PI-PADS was 0. 731,indicating its high diagnostic value for puncture results (P < 0. 05). Moreover,the AUC of the combined indicators (f/t PSA,PI-PADS) was 0. 775,demonstrating their high diagnostic value for prostate biopsy results (P < 0. 05) with significant statistical significance. Conclusion:In patients with PSA levels below 20 ng/m L,the PI-PADS score,f/t PSA,and the combination of PI-PADS and f/t PSA are important factors influencing positive prostate biopsy outcomes.更多还原