THE ROLE OF NEW MARKERS IN THE DIFFERENTIAL DIAGNOSIS OF PROSTATE CANCER

Abstract

AIM: to determine the significance of [-2]proPSA and prostate health index for the diagnostics of prostate diseases in patients with PSA level in blood plasma less than 4 ng/ml. PATIENTS AND METHODS: 148 men were examined in the urology clinic of Pavlov First Saint Petersburg State Medical University for the exclusion of prostate cancer (PCa). The inclusion criteria were: the level of total PSA in blood plasma less than 4 ng/ml, the presence of changes in the prostate during digital rectal examination, the detection of hypoechoic sites according to transabdominal ultrasound examination of the prostate or a decrease in the ratio of free and total PSA in blood plasma less than 15%. For all the patients the level of [-2]proPSA was assessed, its percentage to total PSA and the prostate health index were calculated. Based on the results of the biopsy, all patients were divided into 3 groups. Patients with histopathomorphologically verified benign prostatic hyperplasia (BPH) were included in the first group (83 patients), in the second group (14 patients) - with prostatic intraepithelial neoplasia (PIN), in the third (51 patients) - patients who had focal atypia and/or adenocarcinoma of the prostate. Clinical and laboratory parameters were compared between the abovementioned groups. RESULTS: Prostate health index was found to be the most significant factor of difference comparing patients with BPH and PCa, as well as in the presence of PIN and PCa (p<0.001 for both), while a statistically significant difference in this indicator was not obtained comparing BPH and PIN patients. CONCLUSION: Prostate health index showed the greatest prognostic value in the diagnostics of prostate diseases in patients with PSA level in blood plasma less than 4 ng/ml.