To retrospectively describe the transperineal prostate puncture in our center, explore the key factors affecting the positive rate of puncture, and compare the differences between simple systematic puncture and systematic combined targeted puncture.

A total of 2 722 patients who underwent transperineal prostate puncture in our center from June 2017 to December 2019 were included. Measurement and enumeration data were compared using t tests and chi-square tests, and logistic regression models were used to analyze the key factors affecting the positive rate of puncture.

The average age was (67±8) years, the average BMI was (24.3±3.0) kg/m², and the median PSA was 11.59 ng/ml. 190 patients (6.9%, 190/2 722) had a prior puncture. There were 933 patients who underwent systematic and targeted puncture (34.3%, 933/2 722). Postoperative major complications occurred in 60 patients (2.20%, 60/2 722). Pathological results showed that 1 439 cases were definitely diagnosed as prostatic acinar adenocarcinoma, and the positive rate of puncture was 52.8%(1 439/2 722). Logistic regression analysis showed that age >70 years (OR=3.67, 2.55-5.30, P<0.01), PSA >20 ng/ml (OR=35.83, 19.02-67.48, P<0.01) and targeted combined systematic puncture (OR=2.89, 2.39-3.48, P<0.01) were the key factors for the diagnosis of prostate cancer. Further comparison of the difference between systematic puncture alone and systematic combined targeted puncture revealed that the number of patients with combined targeted PSA <20 ng/ml was significantly higher than that in the systematic puncture alone group (83.9% vs 65.7%, P<0.01). The proportion of patients with previous puncture history was higher in the combined targeted group (12.2% vs 4.2%, P<0.01). The combined targeting group significantly increased the positive rate of puncture (64.0% vs 47.1%, P<0.01).

Transperineal prostate puncture is safe and effective. Age, high PSA levels, and targeted paracentesis are key factors in the diagnosis of prostate cancer. Multi-parameter MR-guided targeted puncture can improve the positive rate of puncture, especially under the premise of low PSA and repeated puncture, multi-parameter MR-guided targeted puncture is recommended..