Cancer - Prostate(구연) MP Session Ⅰ (MP-004) Geumkang Hall (Avenue 2F) 11월 28일(수) 16:00-17:00 두 번째 전립선 생검에서 임상적으로 의미있는 전립선 암 예측인자 ¹경북대학교 의학전문대학원 비뇨의학과교실 ²경북대학교병원 비뇨의학과 ³칠곡경북대학교병원 비뇨의학과 하헌², 오정석², 강준구³, 정재욱³, 하윤석², 최석환¹·², 이준녕¹·³, 김범수¹·², 김태환¹·³, 유은상¹·², 권태균¹·³, 정성광¹·², 김현태¹·³ Purpose: A number of patients who were negative in the initial biopsy were identified in the second biopsy. It is important to identify factors that predict cancer in a second biopsy. We evaluated the factors for predicting positive repeat biopsy in patients with negative initial prostate biopsy. Methods: This study enrolled 211 patients who were not detected prostate cancer on initial transrectal ultrasound guided prostate biopsy underwent second biopsy in our institution from Jan 2011 to Dec 2017. Among them, we excluded the patients who did not perform blood test including AST/ALT or had hepatitis or was not followed up regularly. Finally, 124 patients met these criteria and we retrospectively reviewed the medical records. Group 1 (n=82) was defined as patients without prostate cancer on second prostate biopsy, group 2 (n=42) was defined as patients who were detected prostate cancer on second prostate biopsy. Among group 2, 17 patients were shown as low risk prostate cancer according to D’amico classification. Group 2A (n=99) was defined as group 1 plus these 17 patients. Group 2B (n=25) was defined as the other non-low risk prostate cancer patients. Results: Mean age was 63.79±8.54 and mean initial PSA was 6.78±3.30 ng/mL. Age of group 2 was significantly higher than group 1 (p=0.006). Group 2 had more [ASAP or HGPIN≥3] cores detection on initial biopsy than group 1 (p=0.011). De Ritis ratio was significantly higher in group 2 (1.23±0.44 versus 1.39±0.36, p=0.045). Multivariate analysis showed that age (HR 1.089, 95% CI 1.025-1.157; p=0.006) and [ASAP or HGPIN≥3] cores detection (HR 4.067, 95% CI 1.470-11.257; p=0.007) on initial biopsy were the only predicting factors for positive second biopsy. When we classified the patients as benign plus low risk prostate cancer (group 2A) versus non-low risk prostate cancer (group 2B), age (HR 1.148, 95% CI 1.053-1.25; p=0.002) and De Ritis ratio (HR 6.001, 95% CI 1.720-20.933; p=0.005) was significantly higher in group 2B in multivariate analysis. Conclusion: Age and [ASAP or HGPIN≥3] cores detection on initial biopsy were associated with detection of prostate cancer on second biopsy. In addition, age and De Ritis ratio were found to be predictive factors for the detection of clinically significant prostate cancer on second biopsy. keywords : De Ritis ratio, Prostate biopsy, HGPIN