对良性前列腺增生 (BPH) 手术标本进行组织病理学检查可以检测偶发前列腺癌 (iPCa)。我们研究的目的是为正在考虑进行 BPH 手术的患者开发 iPCa 诊断的预测模型。我们对 2012 年至 2022 年间在三个学术中心接受 BPH 手术的患者的医疗档案进行了回顾性分析。手术前的PCa被排除。我们计算了总体 iPCa 率和有临床意义的 iPCa 率（分级组≥2）。使用单变量和多变量回归模型来评估 iPCa 的预测因素。比较每个风险因素和全局模型的受试者工作特征曲线下面积 (AUC)。我们使用χ2自动交互检测（CHAID）进行决策树分析。我们纳入了2452例患者进行分析，其中247例（10.0%）患有iPCa，其中49/247例（20.2%）具有临床意义。多变量分析显示，年龄和前列腺特异性抗原密度（PSAD）是 iPCa 诊断的独立预测因素。包含年龄和 PSAD 的模型的 AUC 为 0.65。 CHAID 分析显示，PSAD > 0.1 ng/ml/cm3 的患者 iPCa 风险为 23.4% (χ2 = 52.6；p < 0.001)。对于这些患者，年龄 >72 岁会使 iPCa 风险增加至 35.4% (χ2 = 11.1，p = 0.008)。我们的研究主要受限于其回顾性设计。年龄和PSAD是iPCa诊断的独立危险因素。年龄 > 72 岁和 PSAD > 0.1 ng/ml/cm3 的组合与 35.4% 的 iPCa 率相关。我们进行了一项研究，旨在为接受前列腺良性增大手术的患者寻找前列腺癌的预测因子。我们的模型可以识别处于危险中的患者，并在手术前诊断他们的癌症。这可以避免不必要或有害的程序。版权所有 © 2024 作者。由 Elsevier B.V. 出版。保留所有权利。

Histopathological examination of surgical specimens for benign prostatic hyperplasia (BPH) can detect incidental prostate cancer (iPCa). The aim of our study was to develop a predictive model for iPCa diagnosis for patients for whom BPH surgery is being considered.We conducted a retrospective analysis of medical files for patients who underwent BPH surgery in three academic centers between 2012 and 2022. Patients diagnosed with PCa before surgery were excluded. We calculated the global iPCa rate, and the clinically significant iPCa rate (grade group ≥2). Univariate and multivariable regression models were used to assess factors predictive of iPCa. The area under the receiver operating characteristic curve (AUC) was compared for each risk factor and for the global model. We used χ2 automated interaction detection (CHAID) for decision tree analysis.We included 2452 patients in the analysis, of whom 247 (10.0%) had iPCa, which was clinically significant in 49/247 cases (20.2%). Multivariable analysis revealed that age and prostate-specific antigen density (PSAD) were independent predictive factors for iPCa diagnosis. The AUC for a model including age and PSAD was 0.65. CHAID analysis revealed that patients with PSAD >0.1 ng/ml/cm3 had an iPCa risk of 23.4% (χ2 = 52.6; p < 0.001). For those patients, age >72 yr increased the iPCa risk to 35.4% (χ2 = 11.1, p = 0.008). Our study is mainly limited by its retrospective design.Age and PSAD were independent risk factors for iPCa diagnosis. The combination of age >72 yr and PSAD >0.1 ng/ml/cm3 was associated with an iPCa rate of 35.4%.We performed a study to find predictors of prostate cancer for patients undergoing surgery for benign enlargement of the prostate. Our model can identify patients at risk, and diagnose their cancer before surgery. This could avoid unnecessary or harmful procedures.Copyright © 2024 The Author(s). Published by Elsevier B.V. All rights reserved.