Evaluation of the Effectiveness of Multifocal Puncture Biopsy in the Diagnosis of Prostate Cancer

Introduction. The value of multifocal puncture biopsy of the prostate is undoubtedly extremely important today for the timely diagnosis of prostate cancer. Despite the fact that the main disadvantage of multifocal biopsy compared to modern methods of prostate biopsy under the control of multiparametric magnetic resonance imaging is the high frequency of false-negative results, these methods are not competitive, but to some extent, complement each other. Aim. To improve the results of prostate cancer diagnostics by identifying prognostically significant criteria for evaluating the results of multifocal prostate biopsy. Materials and methods. The study included 101 patients with indications for multifocal prostate biopsy. After examination, 78 (77.2%) patients were diagnosed with prostate cancer. Another 23 (22.8%) patients were diagnosed with benign prostatic hyperplasia. To assess the effectiveness of multifocal puncture biopsy, the following indicators were determined: blood test for total prostate-specific antigen (ng/ml); prostate volume according to magnetic resonance imaging (cm3); prostate-specific antigen density (ng/ml/cm3); localization of the lesion according to magnetic resonance imaging; size of the lesion; sensitivity and specificity of magnetic resonance imaging in the detection of prostate cancer. Quantitative indicators were processed statistically. Results. The main factors that increase the detection of prostate cancer using multifocal biopsy are: total prostate-specific antigen level in the blood ≥12.79 ng/ml (p=0.044), prostate volume ≥42.91 cm3 (p=0.019), prostate-specific antigen density ≥0.33 ng/ml/cm3 (p=0.027), size of the pathological prostate lesion ≥10.74 mm (p=0.045) and location of the lesion in the peripheral area of the prostate (p=0.004). Conclusions. To increase the effectiveness of multifocal puncture biopsy, the standard differential diagnosis program for prostate cancer should include a combined determination of total prostate-specific antigen levels in the blood, prostate volume, prostate-specific antigen density, and lesion size.