Objective To compare the detection rate between ultrasound-guided transperineal(TRB)and transrectal(TPB)prostate biopsies for prostate cancer(PCa),evaluate their impact on the consistency of international society of uological pathology(ISUP)grade post-laparoscopic radical prostatectomy(LRP),and analyze the independent factors affecting PCa detection rate.Methods The medical records of 619 patients who underwent ultrasound-guided prostate biopsy in Central Hospital of Wuhan Affiliated to Tongji Medical College of Huazhong University of Science and Tech-nology from January 2018 to December 2022 were retrospectively analyzed.They were divided into TRB group(n=357)and TPB group(n=262)according to the puncture route.Chi-square test was used to compare the detection rate of PCa between two puncture approaches and the influence on the ISUP grade inconsistency after LRP.Univariate Logistic regression and forward stepwise Logistic regression were used to analyze the independent influencing factors in PCa detection rate.Results The detection rates of TRB group and TPB group were 46.8%and 55.0%respectively,and the difference was statistically significant(P=0.044).The upgrading rates of ISUP grade rates in TRB group and TPB group were 45.7%and 30.4%respectively,and the difference was statis-tically significant(P=0.039).The postoperative degradation rates of ISUP grade in TRB group and TPB group were 4.9%and 12.0%,respectively,and there was no significant difference(P=0.102).Multiva-riate Logistic regression analysis showed that age(OR=1.598,95%CI:1.266-2.016,P<0.001),pros-tate specific antigen density(PSAD)(OR=1.764,95%CI:1.318-2.359,P<0.001),percentage of free prostate specific antigen(%fPSA)(OR=0.750,95%CI:0.590-0.953,P=0.019),prostate volume(PV)(OR=0.631,95%CI:0.495-0.804,P<0.001),and prostate imaging reporting and data system(PI-RADS)score(OR=4.910,95%CI:3.650-6.604,P<0.001)were independent influencing factors in PCa detection rate.Conclusions TPB has a higher detection rate of PCa than TRB.Moreover,TPB has obvious advantages in reducing upgrading rates of ISUP grade after LRP.Patient's age,%fPSA,PS-AD,PV,and PI-RADS score were independent influencing factors in PCa.
维普
万方数据