OBJECTIVETo study the relationship of the positive rate of transrectal ultrasound (TRUS) guided prostatic biopsies in detecting prostate cancer with the findings of digital rectal examination (DRE), prostate imaging and measurement of the f/t PSA ratio.

METHODSWe retrospectively analyzed the clinical findings of 365 patients with PSA of 4-10 microg/L who had received DRE, prostate imaging and measurement of the f/t PSA ratio. We performed TRUS guided prostatic biopsies and then analyzed the relationship between the biopsy results and previous findings.

RESULTSOf the 365 patients, 87 (23.84%) were found with prostate cancer by pathological biopsy, and 40 cases of prostate cancer (31.25% ) detected in 128 patients with positive findings in DRE, 26 cases of prostate cancer (37.68%) confirmed in 69 patients with positive findings in TRUS, and 59 cases of prostate cancer (55.14%) revealed in 107 patients with positive findings in MRI. The f/t PSA ratio was significantly lower in the malignant than in the benign cases (P < 0.01), and the area of f/t PSA ROC (0.725) was significantly higher than that of PSA ROC (0.542).

CONCLUSIONDRE, prostate imaging and measurement of the f/t PSA ratio can improve the positive rate of prostate cancer detection, and therefore reduce unnecessary prostatic biopsies.