Abstract
To investigate the value of circulating tumor cells (CTC) in the diagnosis of clinically significant prostate cancer (csPCa). Patients who underwent prostate biopsy under ultrasound guidance and CTC detection at Nantong University Affiliated Hospital from December 2023 to June 2024 were included. Based on the CTC detection results, patients were divided into CTC-positive and negative groups. The baseline information and biopsy pathological results were collected and analyzed. The detection rate of csPCa was compared between two groups. Univariate and multivariate analysis were conducted to explore the independent predictors of csPCa. The diagnostic efficacy was evaluated by ROC curve analysis. 90 patients were enrolled, of whom 46 patients were CTC-positive. 52 patients were diagnosed with csPCa. Patients in the CTC-positive group had higher prostate-specific antigen (PSA) levels (p = 0.001), larger prostate volumes (p = 0.007), higher Prostate Imaging Reporting and Data System (PI-RADS) score (p < 0.001), later clinical stages (p < 0.001), higher biopsy Gleason score (p < 0.001), and higher detection rate of csPCa (p = 0.003). In the univariate analysis, PSA, prostate volume, PI-RADS score, and CTC count were associated with csPCa. In the multivariate analysis, PSA (p = 0.046), PI-RADS score (p = 0.001), and CTC count (p = 0.034) were independent predictors of csPCa. In the Receiver operating characteristic (ROC) curve analysis, the combination of CTC count, PSA, and PI-RADS scores had the largest area under the curve (AUC = 0.913). CTC count is an independent predictor of csPCa. The combination of PSA, PI-RADS score and CTC count is expected to enhance the diagnosis of csPCa.