Factors associated with pathological upgrading in prostate cancer patients with single-needle positive biopsy
Gong Huijie1,2, Niu Shaoxi4, Yan Yongji2, Chen Zhengguang3,*
1First Clinical School of Medicine, Beijing University of Traditional Chinese Medicine,Beijing 100700; 2Department of Urology, Dongzhimen Hospital,Beijing 100700; 3Department of Radiology, Dongzhimen Hospital, Beijing 100700; 4Department of Urology, First Medical Center of the Chinese PLA General Hospital, Beijing 100853
Abstract：Objective： To investigate the risk factors of pathological upgrading after radical prostatectomy in patients with prostate cancer with single-needle positive needle biopsy. Methods： From January 2017 to January 2020, 76 patients with prostate cancer with single needle positive prostate biopsy admitted to the Department of Urology of the First Medical Center of the Chinese PLA General Hospital and Dongzhimen Hospital of Beijing University of Traditional Chinese Medicine were retrospectively analyzed. According to whether the postoperative pathology was upgraded or not, they were divided into pathological upgraded group （39 cases） and pathological unupgraded group （37 cases）. Multivariate logistic regression analysis was used to analyze the risk factors of postoperative pathological progression. Results： Preoperative multiparameter MRI PI-RADS score was 2 in 6 cases （7.9%）,3 in 22 cases （28.9%）,4 in 44 cases （57.9%） and 5 in 4 cases （5.3%）. There was significant difference in PI-RADS score and tPSA between the two groups （P<0.05）. There was no significant difference in age, prostate volume, BMI, PSAD, puncture method and preoperative clinical stage （P>0.05）. Multivariate Logistic regression analysis showed that PI-RADS >3 score was an independent risk factor for postoperative pathological progression of single-needle positive prostate cancer （OR=42.8,95%CI：6.6-278.2;P<0.01）. Conclusion： PI-RADS score based on multiparametric MRI is a risk factor for Gleason score elevation after radical prostatectomy.
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