Prostate puncture biopsy is an invasive test to confirm the diagnosis of prostate cancer. It is usually performed under the guidance of transrectal ultrasound (TRUS) by inserting a puncture biopsy needle into the prostate and removing strips of prostate tissue for pathological examination, which is the gold standard for the diagnosis of prostate cancer. This is the gold standard for the diagnosis of prostate cancer. Prostate puncture biopsy has been used for decades, and a large number of clinical practice studies have shown that puncture biopsy is basically free of tumor metastasis. Prostate anatomy diagram What conditions require prostate puncture? In 2016, the consensus of Chinese experts (Chinese Medical Association Urology Branch and Chinese Prostate Cancer Alliance) on prostate puncture: Indications for initial puncture (if one of the following is present): 1. Suspicious nodules in the prostate found by rectal examination (DRE); 2. Suspicious lesions found by transrectal ultrasound TRUS or magnetic resonance imaging (MRI); 3. Serum prostate-specific antigen (PSA) value >10ng/ml. 4, PSA value between 4-10 ng/ml, suspicious free PSA ratio (f/tPSA) or suspicious PSA density value (PSAD). Indications for repeat puncture (with one of the following): 1. First puncture pathology reveals atypical hyperplasia or high-grade intraepithelial neoplasia (PIN), especially multiple-needle pathology for atypical hyperplasia or high-grade PIN; 2. Repeat PSA value >10 ng/ml; 3. Repeat PSA value between 4-10 ng/ml with abnormal f/tPSA, PSAD, DRE or TRUS, and MRI and other imaging examinations found suspicious lesions; 4, review PSA value between 4-10 ng/ml, f/tPSA, PSAD, DRE or imaging performance are normal, every three months to review PSA, two consecutive >10 ng/ml or PSA rate >0.75 ng/ml/year. Note: 1. serum prostate-specific antigen (PSA), normal reference value 0-4 ng/ml, if PSA is increased, it indicates the presence of benign lesions such as prostate cancer or prostate hyperplasia; 2. free PSA ratio (free PSA/total PSA value, f/tPSA), normal reference value >0.16; 3. PSA density value (PSA value/prostate volume, PSAD), normal reference value <0.15 ng/ml2.