AB189. Prevalence and risk factors of prostate cancer in Chinese men with PSA 4–10 ng/mL underwent TRUS-guided prostate biopsy: the utilization of PAMD score

Objective: To elucidate the characteristics and risk factors for positive biopsy outcomes in Chinese patients with prostate specific antigen (PSA) 4–10 ng/mL, and develop a risk-stratification score model.

Methods: The data of 345 patients underwent transrectal ultrasound-guided prostate biopsy between 2011 and 2013 was retrospectively analyzed. Digital rectal examination (DRE), prostate volum (PV), magnetic resonance imaging (MRI) and smoking status were also collected. Positive biopsy outcomes were defined as prostate cancer (PCa) and high grade PCa (HGPCa, Gleason Score ≥Th.

Results: The median PSA was 7.15 (IQR 5.91–8.45) ng/mL. Overall 138 patients (40.0%) were shown to have PCa, including 100 patients (29.0%) with HGPCa. Smaller PV, elder age, MRI results and positive DRE were proved to be predictive factors for positive biopsy outcomes in both univariate and multivariate analysis. We developed a “PAMD” score which combined the four factors to category patients into three risk groups, and the model performed good predictive sensitivity and specificity.

Conclusions: The prevalence of prostate cancer in Chinese patients with PSA 4–10 ng/mL was 40%, including 29% patients with high grade disease. DRE, age, MRI and PV were predictive factors for positive biopsy outcomes, and the PAMD score model could be utilized for risk-stratification and decision-making.

Keywords: Prostate cancer; prostate specific antigen (PSA); prostate volume