The rapid and accurate acquisition of prostate cancer pathological tissue is critical to prostate cancer research but has traditionally proven challenging. However, the gradual application of three-dimensional (3D) modeling in medical practice has overcome many of the related limitations. This cohort study aimed to compare the difference between a 3D stereotaxic sampling method and traditional cognitive sampling method to clarify the factors affecting sampling. An analysis of 111 men who received radical prostatectomy for prostate cancer at The First Affiliated Hospital of Soochow University between November 2020 and April 2022 was conducted. The positive rate of the cognitive sampling method and the 3D stereotaxic sampling method and their respective influencing factors, such as age, body mass index (BMI), prostate-specific antigen (PSA), PSA density (PSAD), International Society of Urological Pathology (ISUP) grade, tumor volume, number of positive needles from perineal puncture, clinical T stage, and tumor image location, were compared and analyzed, and a cohort study was conducted. Among the 111 patients, there were 57 cases of cognitive sampling and 54 cases of 3D stereotaxic sampling. In this study, the positive rate of cognitive sampling was 29.82% (17/57,), and the positive rate of 3D stereotaxic sampling was 61.11% (33/54), with the positive rate of 3D stereotaxic sampling being significantly higher than that of cognitive sampling (P=0.001). In cognitive sampling, tumor volume [odds ratio (OR) =1.10; 95% confidence interval (CI): 1.02-1.20], number of positive biopsy cores (OR =1.30; 95% CI: 1.06-1.60), Prostate Imaging Report and Data System (PI-RADS) score (OR =5.54; 95% CI: 1.60-19.12), and clinical T stage (OR =2.36; 95% CI: 1.31-4.25) were identified as influencing factors; in 3D stereotaxic sampling, these influencing factors were eliminated, with ORs of 1.22 (95% CI: 0.78-1.90), 0.88 (95% CI: 0.72-1.09), 1.09 (95% CI: 0.62-1.92), and 1.51 (95% CI: 0.86-2.65), respectively, representing a statistically significant difference (P<0.05). The 3D stereotaxic sampling method can accurately obtain the required prostate cancer tissue from the prostate in vitro within a short time, and the factors affecting the positive rate of sampling can be eliminated.
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