Correlation between Gleason score distribution and Prostate Health Index in patients with prostate-specific antigen values of 2.5–10 ng/mL

Abstract

Purpose To determine the clinical significance and correlation between the Prostate Health Index (PHI) and Gleason score in patients with a prostate-specific antigen (PSA) value of 2.5–10 ng/mL. Materials and Methods This retrospective analysis included 114 patients who underwent biopsy after completion of the PHI from November 2018 to July 2019. Various parameters such as PSA, PHI, PSA density, free PSA, p2PSA, and %free PSA were collected, and correlations with biopsy Gleason score and cancer detection rates were investigated. Results Baseline characteristics were comparable between PHI groups (0–26.9 [n=11], 27.0–35.9 [n=17], 36.0–54.9 [n=50], and ≥55.0 [n=36]). A total of 37 patients (32.5%) were diagnosed with prostate cancer, and 28 (24.6%) were diagnosed with clinically significant prostate cancer (CSPC, Gleason score ≥7) after prostate biopsy. The cancer detection rate gradually increased with a corresponding increase in the PHI (18%, 24%, 30%, and 44%, respectively). The same pattern was observed with detecting CSPC (0%, 18%, 26%, and 33%, respectively). There was no CSPC in the groups with PHI <27.0, and Gleason score 7 began to appear in groups with PHI ≥27.0. In particular, patients with Gleason score 8 and 9 were distributed only in the groups with PHI ≥36.0. Conclusions The diagnostic accuracy of detection of CSPC could be increased when prostate biopsy is performed in patients with a PHI ≥36.0. In this study, there was a clear Gleason score difference when the PHI cutoff value was set to 27.0 or 36.0.

New insights on the early prostate cancer diagnosis in a real-world setting

“…Collectively, supporting data suggest that considering sensitivity and diagnostic accuracy by mpMRI study for PCa, implementing models such as multivariate might decrease the number of biopsies by 5% compared with mpMRI approach. This in concordance with Korean study from Choi et al [ 7 ], correlates the diagnostic accuracy of CSPCa detection could be increased when prostate biopsy is assessed in patients with a Prostate Health Index (PHI) ≥36.0. Interestingly, their study from Samsung Medical Center (Seoul, Korea) revealed that there was a clear Gleason score difference when the PHI cutoff value was set to 27.0 or 36.0 summarizing PHI is an additional tool that can be used as a selection criteria for biopsy, especially in patients with a PSA value ranging from 2.5 and 10 ng/mL [ 7 ].…”

New strategy for the identification of prostate cancer: The combination of Proclarix and the prostate health index

“…Thus, 27 might not be the ideal cut‐off when discriminating csPCa from iPCa or no PCa. Nevertheless, a PHI value of 27 was reported in several clinical studies either as cut‐off or as upper limit of a low‐risk range in relation to csPCa 9,24–26 …”

Molecular Biomarkers for the Detection of Clinically Significant Prostate Cancer: A Systematic Review and Meta-analysis

“…Three of these could not be retrieved [17] , [18] , [19] . Sixty-five studies [20] , [21] , [22] , [23] , [24] , [25] , [26] , [27] , [28] , [29] , [30] , [31] , [32] , [33] , [34] , [35] , [36] , [37] , [38] , [39] , [40] , [41] , [42] , [43] , [44] , [45] , [46] , [47] , [48] , [49] , [50] , [51] , [52] , [53] , [54] , [55] , [56] , [57] , [58] , [59] , [60] , [61] , [62] , [63] , [64] , [65] , [66] , [67] , [68] , [69] , [70] , [71] , [72] , [73] , [74] , [75] , [76] , [77] , [78] , [79] , [80] , [81] , [82] , [83] , [84] , reported in 69 articles [20] , [21] ,…”

“…TRUS-guided prostate biopsy from 10 to 12 cylinders 2. Elevated PSA (2.00–20.00 ng/ml) NR Caucasians Asians 2.00–10.00 d 2.00–10.00 d Choi (2020) [61] 114 37 28 Gleason ≥7 62.81 a 7.87 a NR 1. Biopsied with previous PSA and PHI 2.…”

“…The diagnostic tests analyzed were Prostate Health Index (PHI), a mathematical combination of free and total PSA and the [-2]pro-PSA isoform (Beckman Coulter, Inc.), in 37 studies [20] , [22] , [24] , [25] , [29] , [30] , [32] , [38] , [43] , [46] , [47] , [48] , [52] , [54] , [58] , [59] , [60] , [61] , [62] , [64] , [65] , [67] , [72] , [73] , [74] , [75] , [76] , [77] , [80] , [83] , [87] , [89] , [90] , [91] , [92] , [93] , [94] ; Progensa prostate cancer antigen 3 (PCA3; Gen-Probe Incorporated) in 12 studies [23] , [28] , [41] , [50] , [51] , [52] , [53] , [55] , [66] , [81] , [82] , [95] ; PHI density in five studies [20] , [26] , [38] , [59] , [90] ; SelectMDx in five studies [36] , [42] , [49] , [57] , [78] ; 4Kscore test (OPKO Health, Inc.) in four studies [27] , [34] , [42] , …”