Prostate health index significantly reduced unnecessary prostate biopsies in patients with PSA 2-10 ng/mL and PSA &gt;10 ng/mL: Results from a Multicenter Study in China

Na, Rong; Ye, Dingwei; Qi, Jun; Liu, Fang; Helfand, Brian T.; Brendler, Charles B.; Conran, Carly; Packiam, Vignesh T.; Gong, Jian; Wu, Yishuo; Zheng, S. Lilly; Mo, Zengnan; Ding, Qiang; Sun, Yinghao; Xu, Jianfeng

doi:10.1002/pros.23382

Cited by 26 publications

(35 citation statements)

References 22 publications

(44 reference statements)

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“…They could help to distinguish PCa from benign prostate tissue, and there was also a tendency to discriminate aggressive (GS

\geq

7) from potentially indolent forms of PCa. The AUC of %p2PSA and PHI were similar to other Asian series [20–23].…”

Section: Discussionsupporting

confidence: 83%

“…In a prospective, multicenter study in Shanghai, Na et al. showed the better predictive performance of PHI over total PSA both in patients with a PSA level of 2.1–10 ng/mL and also in those with a PSA level >10 ng/mL (Table 5) [23].…”

Section: Discussionmentioning

confidence: 99%

“…suggested a PHI threshold of 27 to achieve the best specificity of 58.3% and 49.8%, respectively [20,21]. In Na's series of patients with a PSA level of 2.1–10 ng/mL, a PHI cutoff of 35 resulted in a sensitivity of 83.09% and specificity of 70.23% [23]. In the present study, a PHI cutoff value of 20.7 resulted in a sensitivity of around 90% but specificity of only 30.5%.…”

Section: Discussionmentioning

confidence: 99%

“…Its derivatives, %p2PSA and PHI, have been shown to improve the prediction of outcomes of prostate biopsies and define cancer aggressiveness [15–18]. p2PSA and PHI have also been applied in Asian populations in several validation studies [19–23]. However, to the best of our knowledge, no study has investigated p2PSA or PHI in Taiwanese men.…”

Section: Introductionmentioning

confidence: 99%

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

Hsieh

Chang

Yang

et al. 2018

The Kaohsiung J of Med Scie

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In this study, we aimed to validate the Prostate Health Index (PHI) for the detection of prostate cancer (PCa). We prospectively enrolled patients aged 50-75 years with a serum prostate specific antigen (PSA) level of 4-10 ng/mL undergoing transrectal biopsy of the prostate between April 2016 and May 2017. The primary outcome was the diagnostic performance of various PSA derivatives (total PSA, free PSA, %fPSA, p2PSA, %p2PSA, and PHI) to predict PCa. The secondary outcome was comparisons of PSA derivatives between patients with a Gleason score (GS) ≤6 and GS ≥7. PCa was diagnosed in 36 of 154 (23.4%) patients, and 26 (16.9%) had a GS ≥7. The areas under the receiver operating characteristic curves were significantly greater in %p 2PSA and PHI than in PSA (0.76 vs. 0.57, p = 0.015 and 0.77 vs. 0.57, p = 0.004, respectively). Patients with a GS ≥7PCa had marginally higher %p2PSA and PHI than those with a GS of 6 (17.8 vs. 12.73, p = 0.06; 46.58 vs. 31.55, p = 0.05). At a PHI cutoff value of 29.6, the sensitivity and specificity were 77.8% and 67.8% in detecting PCa, respectively. In addition, 57.1% of the patients avoided an unnecessary biopsy, while three patients (1.9%) with GS 7 PCa were missed. In conclusion, the ability of %p2PSA and PHI to predict prostate biopsy outcome was better than that of PSA and %fPSA in the initial biopsy in Taiwanese men with serum PSA between 4 and 10 ng/mL.

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“…They could help to distinguish PCa from benign prostate tissue, and there was also a tendency to discriminate aggressive (GS

\geq

7) from potentially indolent forms of PCa. The AUC of %p2PSA and PHI were similar to other Asian series [20–23].…”

Section: Discussionsupporting

confidence: 83%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

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

Hsieh

Chang

Yang

et al. 2018

The Kaohsiung J of Med Scie

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“…In NCCN guideline of PC early detection, PHI > 35 was suggested to estimate highgrade cancer [25]. However, in some Eastern Asian studies, at sensitivity of 90%, the cutoff of PHI was set ranging from 24.9 to 32 [26][27][28]. A recent multicenter study recommended PHI > 30 to predict high-grade (GS ≥ 7) cancer in Asian men, whereas the threshold should be > 40 for European men [21].…”

Section: Discussionmentioning

confidence: 99%

Combining prostate health index and multiparametric magnetic resonance imaging in the diagnosis of clinically significant prostate cancer in an Asian population

Hsieh

Lin

et al. 2019

World J Urol

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Objective To evaluate the practicability of combining prostate health index (PHI) and multiparametric magnetic resonance imaging (mpMRI) for the detection of clinically significant prostate cancer (csPC) in an Asian population. Patients and methodsWe prospectively enrolled patients who underwent prostate biopsy due to elevated serum prostatespecific antigen (PSA > 4 ng/mL) and/or abnormal digital rectal examination in a tertiary referral center. Before prostate biopsy, the serum samples were tested for PSA, free PSA, and p2PSA to calculate PHI. Besides, mpMRI was performed using a 3-T scanner and reported in the Prostate Imaging Reporting and Data System version 2 (PI-RADS v2). The diagnostic performance of PHI, mpMRI, and combination of both was assessed. Result Among 102 subjects, 39 (38.2%) were diagnosed with PC, including 24 (23.5%) with csPC (Gleason ≥ 7). By the threshold of PI-RADS ≥ 3, the sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) to predict csPC were 100%, 44.9%, 35.8%, and 100%, respectively. By the threshold of PHI ≥ 30, the sensitivity, specificity, PPV, and NPV to predict csPC were 91.7%, 43.6%, 33.3%, and 94.4%, respectively. The area under the receiver operator characteristic curve of combining PHI and mpMRI was greater than that of PHI alone (0.873 vs. 0.735, p = 0.002) and mpMRI alone (0.873 vs. 0.830, p = 0.035). If biopsy was restricted to patients with PI-RADS 5 as well as PI-RADS 3 or 4 and PHI ≥ 30, 50% of biopsy could be avoided with one csPC patient being missed. Conclusion The combination of PHI and mpMRI had higher accuracy for detection of csPC compared with PHI or mpMRI alone in an Asian population.

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Genome‐Wide 3′‐UTR Single Nucleotide Polymorphism Association Study Identifies Significant Prostate Cancer Risk‐Associated Functional Loci at 8p21.2 in Chinese Population

et al. 2022

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MicroRNAs (miRNAs) are involved in the regulation of gene expression via incomplete base pairing to sequence motifs at the three prime untranslated regions (3′‐UTRs) of mRNAs and play critical roles in the etiology of cancers. Single nucleotide polymorphisms (SNPs) in the 3′‐UTR miRNA‐binding regions may influence the miRNA affinity. However, this biological mechanism in prostate cancer (PCa) remains unclear. Here, a three‐stage genome‐wide association study of 3′‐UTR SNPs ( n =33 117) is performed in 5515 Chinese men. Three genome‐wide significant variants are discovered at 8p21.2 (rs1567669, rs4872176, and rs4872177), which are all located in a linkage disequilibrium region of the NKX3‐1 gene. Phenome‐wide association analysis using the FinnGen data reveals a specific association of rs1567669 with PCa over 2,264 disease endpoints. Expression quantitative trait locus analyses based on both Chinese PCa cohort and the GTEx database show that risk alleles of these SNPs are significantly associated with low expression of NKX3‐1 . Based on the MirSNP database, dual‐luciferase reporter assays show that risk alleles of these SNPs downregulate the expression of NKX3‐1 via increased miRNA binding. These results indicate that the SNPs at the 3′‐UTR of NKX3‐1 significantly downregulate NKX3‐1 expression by influencing the affinity of miRNA and increase the PCa risk.

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Prostate health index significantly reduced unnecessary prostate biopsies in patients with PSA 2-10 ng/mL and PSA >10 ng/mL: Results from a Multicenter Study in China

Abstract: Results from this study suggest that phi can be used to predict PCa and high-grade disease in Chinese men with high PSA levels (>10 ng/mL).

Cited by 26 publications

References 22 publications

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

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

Combining prostate health index and multiparametric magnetic resonance imaging in the diagnosis of clinically significant prostate cancer in an Asian population

Genome‐Wide 3′‐UTR Single Nucleotide Polymorphism Association Study Identifies Significant Prostate Cancer Risk‐Associated Functional Loci at 8p21.2 in Chinese Population

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