[Transrectal ultrasonography of intravesical prostatic protrusion and the detection rate of clinically significant prostate cancer].

Objective: To investigate the value of transrectal ultrasonography (TRUS) in the detection of clinically significant prostate cancer (CsPCa) in patients with intravesical prostatic protrusion (IPP).

Methods: We retrospectively analyzed the data on 128 patients undergoing TRUS-guided prostate biopsy in the General Hospital of Eastern Theater Command and Jiangsu Province Hospital from January 2019 to December 2022. We measured the size of and graded IPP, compared the clinicopathological and ultrasonographic features of the patients in the CsPCa group (Gleason score ≥7) and those in the control group (Gleason score <7), and analyzed the correlation of the IPP grades with the detection rate of CsPCa by multivariate logistic regression analysis.

Results: The prostate volume was significantly higher in the CsPCa group than in the control (［51.3±12.1］ vs ［43.5±11.3］ ml, P< 0.05), while the PSA density (PSAD) remarkably lower in the former than in the latter (［0.45±1.92］ vs ［0.59±2.14］ ng/ml, P< 0.05) and so was the detection rate of CsPCa in the patients with IPP grade 3 than in those with IPP grades 0, 1 and 2 (56.0% vs 85.4%, 87.1% and 80.6%, P< 0.05). Spearman correlation analysis showed that the Gleason score was correlated positively with the prostate volume (r = 0.612) but negatively with PSAD (r = －0.735) and the IPP grade (r = －0.619) (P< 0.05). Logistic regression analysis indicated that IPP grade 3 (OR: 0.690, 95% CI: 0.380－0.995, P = 0.032) was an independent protective factor for CsPCa.

Conclusion: CsPCa is significantly correlated with the IPP grade, and the detection rate of CsPCa by TRUS-guided biopsy is lower in patients with IPP grade 3 than in those with IPP grades 0－2. Therefore, special attention should be paid to false negative probability in case of high-grade IPP.