The diagnostic value of prostate health index for prostate cancer

Abstract

Objective To investigate the role of prostate health index(PHI)in prostate cancer detection with a serum prostate specific antigen(PSA) level of 4- 10μg/L and negative digital rectum examination(DRE). Methods In a prospective study from October 2013 to October 2014, the clinical data of 101 old men were analyzed. All the 101 cases were DRE(-), had the serum PSA level of 4- 10μg/L and received prostate biopsy guided by transrectal ultrasound,including 16 cases of prostate cancer and 85 cases of benign prostate diseases.Serum total PSA(tPSA), free PSA(f PSA)and proPSA(p2PSA) were detected and% f PSA,% p2PSA and PHI were calculated. Using prostate biopsy for the definite diagnosis of prostate cancer, receiver operating characteristic curves (ROC)of PHI,% p2PSA, p2PSA,% f PSA and tPSA were established and the areas under the curve(AUC) were calculated.The diagnostic value of PHI,% p2PSA, p2PSA,% fPSA and tPSA, and the value of PHI for predicting aggressive prostate cancer were analyzed. Results In the prostate cancer group, average tPSA, fPSA, p2PSA,% fPSA,% p2PSA and PHI were 6.94, 1.27μg/L, 21.49 ng/L, 18.71%, 1.59% and 41.51 respectively, which were different from those in the noncancer group(6.68, 1.34μg/L,13.37 ng/L,20.42%, 1.05% and 27.18).The AUCs of PHI,% p2PSA,% f PSA and tPSA for diagnosis of prostate cancer were 0.777, 0.769, 0.681, 0.590 and 0.580 respectively.In the prostate cancer group with Gleason score≥7, the PHI value was higher than that of the group with Gleason score≤6(P< 0.05). Conclusion PHI can improve the diagnosis accuracy of prostate cancer in patients with the serum PSA level of 4- 10μg/L and DRE(-). PHI has the diagnostic value better than tPSA,% f PSA, p2PSA or% p2PSA.PHI value is positively associated with the aggressive prostate cancer. Key words: Prostate cancer; Prostate health index; Prostate specific antigen