[Influence of prostatic calculi on the results of prostate biopsy in patients with a PSA level of 4－10 μg/L]

Abstract

Objective: To investigate the influence of prostatic calculi on the results of prostate biopsy in patients with a PSA level of 4－10 μg/L.

Methods: We reviewed the clinical data on 317 patients with a PSA level of 4－10 μg/L on prostate biopsy performed in The First Affiliated Hospital of Fujian Medical University between May 2012 and May 2019, concerning age, body mass index (BMI), prostate volume, PSA level, FPSA/TPSA ratio, PSA density (PSAD), scores on Prostate Imaging Reporting and Data System version 2 (PI-RADS), prostatic calculi and pathological findings. Using logistic regression analysis and ROC curves, we evaluated the influence of prostatic calculi on the results of prostate biopsy.

Results: Multivariate analysis showed that age and the PI-RADS score were independent risk factors of positive prostate biopsy, while the prostate volume, FPSA/TPSA ratio and calculus burden were independent protective factors, and that the PI-RADS score was an independent risk factor of clinically significant PCa, while calculus burden and FPSA/TPSA ratio were independent protective factors. Subgroup analysis of the prostatic calculi revealed that the rates of positive prostate biopsy and clinically significant PCa were higher in the patients with calculi in the peripheral zone than in the other groups, but lower in those with calculi in the central or transitional zone than in the peripheral zone and non-calculus groups.

Conclusions: The rates of positive prostate biopsy and clinically significant PCa are low in prostatic calculus patients with a PSA level of 4－10 μg/L, especially in those with calculi in the central or transitional zone.

Keywords: predictive factors; prostate biopsy; prostate-specific antigen; prostatic calculus.