Prostate Health Index (PHI) improves prostate cancer detection at initial biopsy in Taiwanese men with PSA 4–10 ng/mL

Hsieh, Po Fan; Chang, Chao Hsiang; Yang, Chi‐Rei; Huang, Chi‐Ping; Chen, Wen Chi; Yeh, Chun Chieh; Chou, Eric Chieh Lung; Chen, Kuo Liang; Lien, Chi Shun; Chen, Guang Heng; Hsiao, Po‐Jen; Chang, Yi Huei; Wu, Hsi Chin

doi:10.1016/j.kjms.2018.02.007

Cited by 11 publications

(12 citation statements)

References 33 publications

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“…In order to solve these problems, multiparametric magnetic resonance imaging (mpMRI) has been used rather than prostate ultrasound, and the Prostate Imaging-Reporting and Data System (PI-RADS) has been used to detect prostate cancer [7]. Several models to assess the risk of prostate cancer using free PSA, free/total PSA ratio, the 4Kscore Test [8], Prostate Health Index [9], and prostate cancer antigen 3 [10] have been developed [11]. However, for diagnostic accuracy and economic benefits, particularly in the gray zone, there is controversy over the usefulness of these biomarkers [12], and prostate biopsy for confirming prostate cancer still tends to rely on volume-based PSA parameters [13,14].…”

Section: Introductionmentioning

confidence: 99%

Is PSA density of the peripheral zone as a useful predictor for prostate cancer in patients with gray zone PSA levels?

et al. 2021

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Background Serum prostate-specific antigen (PSA) is widely used in screening tests for prostate cancer. As the low specificity of PSA results in unnecessary and invasive prostate biopsies, we evaluated the clinical significance of various PSAs and PSA density (PSAD) related to peripheral zones in patients with gray zone PSA level (4–10 ng/mL). Methods A total of 1300 patients underwent transrectal ultrasonography-guided prostate biopsy from 2014 to 2019. Among them, 545 patients in the gray zone were divided into the prostate cancer diagnosis group and the non-prostate cancer diagnosis group, and PSA, relative extra transitional zone PSA (RETzPSA), estimated post holmium laser enucleation of the prostate PSA (EPHPSA), PSAD, peripheral zone PSA density (PZPSAD) and extra-transitional zone density (ETzD) were compared and analyzed using receiver-operating characteristics (ROC) analysis after 1:1 matching using propensity score. Results Area under the ROC curve values of PSA, EPHPSA, RETzPSA, PSA density, ETzD, and PZPSAD were 0.553 (95% CI: 0.495–0.610), 0.611 (95% CI: 0.554–0.666), 0.673 (95% CI: 0.617–0.725), 0.745 (95% CI: 0.693–0.793), 0.731 (95% CI: 0.677–0.780) and 0.677 (95% CI: 0.611–0.719), respectively. PSAD had 67.11% sensitivity, 71.71% specificity, and 70.34% positive predictive rate at 0.18 ng/mL/cc. ETzD had 69.08% sensitivity, 64.47% specificity, and 66.04% positive predictive rate at 0.04 ng/mL/cc. When the cut-off value of PSAD was increased to 0.18 ng/mL/cc, the best results were obtained with an odds ratio of 5.171 (95% CI: 3.171–8.432), followed by ETzD with 4.054 (95% CI: 2.513–6.540). Conclusions These results suggested that volume-adjusted parameters (ETzD and PSAD) might be more sensitive and accurate than various PSA in gray zone patients who required prostate biopsy to reduce unnecessary biopsy.

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Section: Introductionmentioning

confidence: 99%

Is PSA density of the peripheral zone as a useful predictor for prostate cancer in patients with gray zone PSA levels?

et al. 2021

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“…The best cut-off criterion was PHI > 29.6. If this cut-off criterion had been used in the sample, 88 males would have avoided an unnecessary prostate biopsy and there would have been 8 false-negative cases (17).…”

Section: Discussionmentioning

confidence: 99%

Epidemiological study on more accurate diagnosis of prostate cancer

Kopecký¹,

Navláčilová

Janoutová

et al. 2020

Cent Eur J Public Health

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Objective:The study aimed at assessing the potential benefit of prostate health index (PHI) for early detection of prostate cancer (PCa) and the use of PHI as a marker predicting the presence of PCa before performing prostate biopsy.Methods: The study comprised 55 males who underwent prostate biopsy. Before the procedure, blood samples were collected to test prostate specific antigen (PSA) and free/total PSA ratio (%fPSA) and PHI was calculated. Receiver operating characteristic (ROC) analysis was used to assess the benefit of these values for predicting the presence of PCa.Results: Based on histological examination 31 males were diagnosed with PCa, the remaining 24 were negative. Among the PCa patients, 39% had a Gleason score of 6, 26% had a score of 7 and 35% had a score of 8-10. There were statistically significant differences in PHI and PSA between males with and without PCa. The areas under the ROC curve for %fPSA, total PSA and PHI were 0.712, 0.746 and 0.789, respectively. PHI showed the best predictive ability to estimate biopsy results. If the cut-off criterion PHI > 36.4 (77.42% sensitivity, 66.67% specificity) had been used, 41.7% of males would have avoided unnecessary biopsy. Conclusion:The use of PHI may considerably improve the accuracy of PCa detection in patients with elevated PSA and thus reduce the number of unnecessary biopsies.

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“…3 At present, serum prostate-specific antigen (PSA) levels remain the most commonly used test to detect prostate cancer, and the standard and definitive diagnosis of the disease is via prostate biopsy. However, several studies [4][5][6][7][8][9][10][11][12][13][14][15][16][17][18][19][20][21][22][23] have reported that the serum PSA level can also be elevated in benign conditions, has limited specificity, and results in high rates of over-diagnosis and treatment of indolent prostate cancers. Furthermore, it has a low positive predictive value and results in a significant proportion of negative biopsies which often leads to repeat PSA measurements and biopsies.…”

Section: Introductionmentioning

confidence: 99%

Review of novel liquid-based biomarkers for prostate cancer: towards personalised and targeted medicine

2021

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Background: Prostate cancer is the most commonly diagnosed cancer in men and it is responsible for about 10% of all cancer mortalities in both American and Canadian men. At present, serum prostate-specific antigen levels remain the most commonly used test to detect prostate cancer, and the standard and definitive diagnosis of the disease is via prostate biopsy. Conventional tissue biopsies are usually invasive, expensive, painful, time-consuming, and unsuitable for screening and need to be consistently evaluated by expert pathologists and have limited repeatability. Consequently, liquid biopsies are emerging as a favourable alternative to conventional tissue biopsies, providing a non-invasive and cost-effective approach for screening, diagnosis, treatment and monitoring of prostate cancer patients. Materials and methods: We searched several databases from August to December 2020 for relevant studies published in English between 2000 and 2020 and reporting on liquid-based biomarkers available in detectable quantities in patient bodily fluid samples. In this narrative review paper, we describe seven novel and promising liquid-based biomarkers that potentially account for individual patient variability as well as used in disease risk assessment, screening for early disease detection and diagnosis, identification of patients’ risk for metastatic disease and subsequent relapse, monitoring patient response to specific treatment and providing clinicians the potential to stratify patients likely to benefit from a particular treatment. Conclusions: The concept of precision medicine from prevention to treatment techniques that take individual patient variability into account will depend on the development of effective clinical biomarkers that interrogate key aberrant pathways potentially targetable with molecular targets or immunologic therapies. Liquid-based biomarkers with high sensitivity and specificity for prostate cancer are emerging as minimally invasive, lower risk, readily obtainable and easily repeatable technique for screening for early disease detection and diagnosis, patient stratification at diagnosis into different risk categories, identification of patients’ risk for metastatic disease and subsequent relapse, and real-time monitoring of patient response to specific treatment. Thus, effective liquid-based biomarkers will potentially shift the treatment paradigm of prostate cancer towards more personalised and targeted medicine.

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Prostate Health Index (PHI) improves prostate cancer detection at initial biopsy in Taiwanese men with PSA 4–10 ng/mL

Cited by 11 publications

References 33 publications

Is PSA density of the peripheral zone as a useful predictor for prostate cancer in patients with gray zone PSA levels?

Is PSA density of the peripheral zone as a useful predictor for prostate cancer in patients with gray zone PSA levels?

Epidemiological study on more accurate diagnosis of prostate cancer

Review of novel liquid-based biomarkers for prostate cancer: towards personalised and targeted medicine

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