The modified prostate health index (PHI) outperforms PHI density in the detection of clinical prostate cancer within the PSA grey zone

Shi, Bowen; Wu, Yanyuan; Qian, Yuhang; Zhou, Jun; Zhang, Xi; Ding, Jie; Chen, Hao-Jie

doi:10.1007/s11255-022-03113-8

Cited by 7 publications

(2 citation statements)

References 32 publications

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“…With regards to this, we planned and arranged to reassemble and optimize existing diagnostic prediction models, namely, p2PSA, PHI, and PHID, and attempted to balance the benefit and risk. Recent research has proved that the modified PHI predictive model outperforms PHI density in the early distinguishing of overall prostate cancer and BPH ( 36 ). Based on the logical mechanism of Huang et al., we supposed that LD might increase faster than TRD and APD in csPCa due to the active proliferation of malignant cells in the peripheral zone, which mainly composed the LD measurement.…”

Section: Discussionmentioning

confidence: 99%

Modified Prostate Health Index Density Significantly Improves Clinically Significant Prostate Cancer (csPCa) Detection

Chen

Qian

et al. 2022

Front. Oncol.

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BackgroundEarly screening of clinically significant prostate cancer (csPCa) may offer opportunities in revolutionizing the survival benefits of this lethal disease. We sought to introduce a modified prostate health index density (mPHI) model using imaging indicators and to compare its diagnostic performance for early detection of occult onset csPCa within the prostate-specific antigen (PSA) gray zone with that of PHI and PHID.Methods and ParticipationBetween August 2020 and January 2022, a training cohort of 278 patients (total PSA 4.0–10.0 ng/ml) who were scheduled for a prostate biopsy were prospectively recruited. PHI and PHID were compared with mPHI (LDTRD×APD×TPV×PHI) for the diagnosis performance in identifying csPCa. Pathology outcomes from systematic prostate biopsies were considered the gold standard.ResultsThis model was tested in a training cohort consisting of 73 csPCa, 14 non-clinically significant prostate cancer(non-csPCa), and 191 benign prostatic hyperplasia (BPH) samples. In the univariate analysis for the PSA gray zone cohort, for overall PCa, the AUC of mPHI (0.856) was higher than PHI (0.774) and PHID (0.835). For csPCa, the AUC of mPHI (0.859) also surpassed PHI (0.787) and PHID (0.825). For detection of csPCa, compared with lower specificities from PHI and PHID, mPHI performed the highest specificity (76.5%), by sparing 60.0% of unnecessary biopsies at the cost of missing 11 cases of csPCa. The mPHI outperformed PHI and PHID for overall PCa detection. In terms of csPCa, mPHI exceeds diagnostic performance with a better net benefit in decision curve analysis (DCA) compared with PHI or PHID.ConclusionsWe have developed a modified PHI density (mPHI) model that can sensitively distinguish early-stage csPCa patients within the PSA gray zone.Clinical Trial RegistrationClinicalTrials.gov, NCT04251546.

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Section: Discussionmentioning

confidence: 99%

Modified Prostate Health Index Density Significantly Improves Clinically Significant Prostate Cancer (csPCa) Detection

Chen

Qian

et al. 2022

Front. Oncol.

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“…Despite this, limitations of the crude risk stratification by PHI are disclosed when being validated in external cohorts consisting of different races/ethnicity of participants, populations, and genetic properties ( 3 ). Moreover, recent studies have reported the utility of the imaging assessment from TRUS and mpMRI ( 13 , 14 ). PHI density (PHID) was developed combining with PHI and total prostate volume ( 15 ).…”

Section: Introductionmentioning

confidence: 99%

Serum multi-cytokines screening identifies TRAIL and IL-10 as probable new biomarkers for prostate health index diagnostic utility adjustment in grey zone aggressive prostate cancer detection: A single-center data in China

et al. 2022

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ObjectiveTo identify less invasive and easily applicable serum cytokine-derived biomarkers which contribute to the diagnostic utility and risk assessment ability of the prostate health index (PHI) based multivariable model in grey zone aggressive prostate cancer (AG PCa) early detection.MethodsSerum 45 cytokines screening was performed in a small training cohort consisting of 10 sera by Luminex liquid array-based multiplexed immunoassays and identified TRAIL and IL-10 as new biomarkers for PHI diagnostic utility adjustment for further validation with a multivariable predictive model in a cohort including 79 aggressive prostate cancer patients and 209 benign prostatic hyperplasia or indolent PCa patients within the PSA grey zone.ResultsTRAIL and IL-10 were identified as potential serum biomarkers for AG PCa detection by the result of multi-cytokines screening in the univariate analysis, while multivariable logistic regression confirmed the AUC of the full risk predictive model (0.915) including tPSA, fPSA, PHI, TRAIL, and IL-10 was higher than various diagnostic strategies. DCA suggested a superior net benefit and indicated a good discriminative ability of the full risk model consistently with the result of the nomogram.ConclusionWe suggest a significant advantage for the PHI-based multivariate combinations of serum TRAIL and IL-10 comparing to PHI or other serum-derived biomarkers alone in the detection and risk stratification of grey zone AG PCa.

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Clinical value of prostate health index as an indicator for recommending magnetic resonance imaging in patients with gray-zone prostate-specific antigen level

Song,

Hwang

et al. 2023

World J Urol

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The modified prostate health index (PHI) outperforms PHI density in the detection of clinical prostate cancer within the PSA grey zone

Cited by 7 publications

References 32 publications

Modified Prostate Health Index Density Significantly Improves Clinically Significant Prostate Cancer (csPCa) Detection

Modified Prostate Health Index Density Significantly Improves Clinically Significant Prostate Cancer (csPCa) Detection

Serum multi-cytokines screening identifies TRAIL and IL-10 as probable new biomarkers for prostate health index diagnostic utility adjustment in grey zone aggressive prostate cancer detection: A single-center data in China

Clinical value of prostate health index as an indicator for recommending magnetic resonance imaging in patients with gray-zone prostate-specific antigen level

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