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Clinical performance of prostate health index in men with tPSA>10ng/ml: Results from a multicentric European study.
- Source :
-
Urologic Oncology . Sep2016, Vol. 34 Issue 9, p415.e13-415.e19. 1p. - Publication Year :
- 2016
-
Abstract
- <bold>Background: </bold>Evidence regarding the diagnostic accuracy of a [-2]proPSA derivative, namely, the prostate health index (PHI), to predict the presence of prostate cancer (PCa) in individuals with high total prostate-specific antigen (tPSA) levels is lacking. We tested the hypothesis that these markers could assist clinicians in the biopsy decision path of patients with tPSA>10ng/ml.<bold>Methods: </bold>The primary endpoint was to evaluate the sensitivity, specificity, and diagnostic accuracy of PHI in determining the presence of PCa at biopsy in comparison to tPSA, free PSA, and % of free to total PSA. We calculated the number of prostate biopsies that could have been spared by using this marker to decide whether or not to perform a biopsy. A secondary endpoint was to determine the relationship between PHI and PCa characteristics.<bold>Results: </bold>The PCa was diagnosed in 136 of 262 patients (51.9%). Total PSA and PHI values were significantly higher (P<0.005) and % of free to total PSA values significantly lower (P<0.0001) in patients with PCa relative to those with a negative biopsy. In multivariable logistic regression models, PHI achieved the independent predictor status and significantly increased the accuracy of the base multivariable model by an extent of 8.2% (P = 0.0005). The inclusion of PHI in the biopsy decision path would decrease the number of unnecessary biopsies by an extent of 50.0%, while missing only few cases with clinically significant PCa. Finally, Gleason score was significantly related to PHI levels.<bold>Conclusions: </bold>The results of our study support the diagnostic effectiveness of PHI even in patients with tPSA >10ng/ml. Further validation studies with larger sample size are needed to corroborate our findings. [ABSTRACT FROM AUTHOR]
Details
- Language :
- English
- ISSN :
- 10781439
- Volume :
- 34
- Issue :
- 9
- Database :
- Academic Search Index
- Journal :
- Urologic Oncology
- Publication Type :
- Academic Journal
- Accession number :
- 117587906
- Full Text :
- https://doi.org/10.1016/j.urolonc.2016.04.003