The percentage of prostate-specific antigen (PSA) isoform [-2]proPSA and the Prostate Health Index improve the diagnostic accuracy for clinically relevant prostate cancer at initial and repeat biopsy compared with total PSA and percentage free PSA in men

2015 ◽  
Vol 117 (1) ◽  
pp. 72-79 ◽  
Author(s):  
Martin Boegemann ◽  
Carsten Stephan ◽  
Henning Cammann ◽  
Sébastien Vincendeau ◽  
Alain Houlgatte ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Diagnostic Accuracy ◽  
Prostate Specific Antigen ◽  
Specific Antigen ◽  
Repeat Biopsy ◽  
Health Index ◽  
Free Psa ◽  
Prostate Health Index ◽  
Total Psa ◽  
Prostate Health

scholarly journals Usefulness of the prostate health index in predicting the presence and aggressiveness of prostate cancer among Korean men: a prospective observational study

BMC Urology ◽  
2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Jae Yoon Kim ◽  
Ji Hyeong Yu ◽  
Luck Hee Sung ◽  
Dae Yeon Cho ◽  
Hyun-Jung Kim ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Observational Study ◽  
Prospective Observational Study ◽  
Specific Antigen ◽  
Significant Proportion ◽  
Health Index ◽  
Free Psa ◽  
Prostate Health Index ◽  
Total Psa ◽  
Prostate Health

Abstract Background We aimed to evaluate the usefulness of the Beckman Coulter prostate health index (PHI) and to compare it with total prostate-specific antigen (PSA) levels and related derivatives in predicting the presence and aggressiveness of prostate cancer (PCa) in the Korean population. Methods A total of 140 men who underwent their first prostate biopsy for suspected PCa were included in this prospective observational study. The diagnostic performance of total PSA, free PSA, %free PSA, [–2] proPSA (p2PSA), %p2PSA, and PHI in detecting and predicting the aggressiveness of PCa was estimated using the receiver operating characteristic curve (ROC) and logistic multivariate regression analyses. Results Of 140 patients, PCa was detected in 63 (45%) of participants, and 48 (76.2%) of them had significant cancer with a Gleason score (GS) ≥ 7. In the whole group, the area under the curve (AUC) for ROC analysis of tPSA, free PSA, %fPSA, p2PSA, %p2PSA, and PHI were 0.63, 0.57, 0.69, 0.69, 0.72, and 0.76, respectively, and the AUC was significantly greater in the PHI group than in the tPSA group (p = 0.005). For PCa with GS ≥ 7, the AUCs for tPSA, free PSA, %fPSA, p2PSA, %p2PSA, and PHI were 0.62, 0.58, 0.41, 0.79, 0.86, and 0.87, respectively, and the AUC was significantly greater in the PHI group than in the tPSA group (p < 0.001). In the subgroup with tPSA 4–10 ng/mL, both %p2PSA and PHI were strong independent predictors for PCa (p = 0.007, p = 0.006) and significantly improved the predictive accuracy of a base multivariable model, including age, tPSA, fPSA and %fPSA, using multivariate logistic regression analysis. (p = 0.054, p = 0.048). Additionally, at a cutoff PHI value > 33.4, 22.9% (32/140) of biopsies could be avoided without missing any cases of aggressive cancer. Conclusions This study shows that %p2PSA and PHI are superior to total PSA and %fPSA in predicting the presence and aggressiveness (GS ≥ 7) of PCa among Korean men. Using PHI, a significant proportion of unnecessary biopsies can be avoided.

The performance of [-2]proPSA and prostate health index tumor markers in prostate cancer diagnosis

2016 ◽  
Vol 40 (6) ◽  
Author(s):  
Joško Osredkar ◽  
Kristina Kumer ◽  
Teja Fabjan ◽  
Gregor Hlebič ◽  
Blaže Podnar ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Tumor Markers ◽  
Specific Antigen ◽  
Area Under The Curve ◽  
Health Index ◽  
Free Psa ◽  
Prostate Health Index ◽  
Prostatic Diseases ◽  
Total Psa ◽  
Prostate Health

AbstractBackground:Prostate-specific antigen (PSA) is an established tumor marker for the diagnosis of patients with prostate cancer. The aim of the study was to evaluate the performance of [-2]proenzyme PSA ([-2]proPSA) and prostate health index (PHI) tumor markers in the differential diagnosis between benign prostatic diseases and prostate cancer.Methods:Total PSA (tPSA), free PSA (fPSA) and [-2]proPSA were measured usingResults:For the prediction of a malignant histopathological result, the specificity at the 90% sensitivity level was 24.3% for [-2]proPSA, 32.4% for %[-2]proPSA, 28.4% for PHI, 18.9% for tPSA and 28.4% for the free-to-total PSA ratio. The area under the curve for [-2]proPSA, %[-2]proPSA, PHI, tPSA and the free-to-total PSA ratio was 0.663, 0.749, 0.742, 0.616 and 0.625, respectively.Conclusions:Our study found a moderate improvement over tPSA and %fPSA in detecting prostate cancer using the [-2]proPSA assay in patients with a tPSA range of 1.6–8.0 µg/L.

scholarly journals The Percentage of [−2]Pro–Prostate-Specific Antigen and the Prostate Health Index Outperform Prostate-Specific Antigen and the Percentage of Free Prostate-Specific Antigen in the Detection of Clinically Significant Prostate Cancer and Can Be Used as Reflex Tests

2021 ◽  
Author(s):  
Manuel M. Garrido ◽  
José C. Marta ◽  
Rui M. Bernardino ◽  
João Guerra ◽  
Francisco Fernandes ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Diagnostic Accuracy ◽  
Prostate Specific Antigen ◽  
Specific Antigen ◽  
Roc Curves ◽  
Nonparametric Tests ◽  
Health Index ◽  
Prostate Health Index ◽  
Clinically Significant ◽  
Prostate Health

Context.— There is a need to avoid the overdiagnosis of prostate cancer (PCa) and to find more specific biomarkers. Objective.— To evaluate the clinical utility of [−2]pro–prostate-specific antigen ([−2]proPSA) derivatives in detecting clinically significant PCa (csPCa) and to compare it with prostate-specific antigen (PSA) and with the percentage of free PSA (%fPSA). Design.— Two hundred thirty-seven men (PSA: 2–10 ng/mL) scheduled for a prostate biopsy were enrolled. Parametric and nonparametric tests, receiver operating characteristic (ROC) curves, and logistic regression analysis were applied. Outcomes were csPCa and overall PCa. Results.— Both [−2]proPSA derivatives were significantly higher in csPCa and overall PCa (P &lt; .001). The areas under the curves for the prediction of csPCa were higher for the percentage of [−2]proPSA (%[−2]proPSA) (0.781) and the prostate health index (PHI) (0.814) than for PSA (0.651) and %fPSA (0.724). There was a gain of 11% in diagnostic accuracy when %[−2]proPSA or PHI were added to a base model with PSA and %fPSA. Twenty-five percent to 29% of biopsies could have been spared with %[−2]proPSA (cutoff: ≥1.25%) and PHI (cutoff: ≥27), missing 10% of csPCa's. The same results could have been achieved by using [−2]proPSA as a reflex test, when %fPSA was 25% or less (cutoffs: ≥1.12% and ≥24 for %[−2]proPSA and PHI, respectively). Conclusions.— The [−2]proPSA derivatives improve the diagnostic accuracy of csPCa, when the PSA value is between 2 and 10 ng/mL, allowing to spare unnecessary biopsies and to select patients for active surveillance. [−2]proPSA can be used as a reflex test when %fPSA is 25% or less, without reducing the diagnostic accuracy for csPCa and the number of spared biopsies.

scholarly journals Usefulness of the Prostate Health Index in Predicting the Presence and Aggressiveness of Prostate Cancer Among Korean Men

2021 ◽  
Author(s):  
Jae-Yoon Kim ◽  
Ji-Hyeong Yu ◽  
Luck-Hee Sung ◽  
Dae-Yeon Cho ◽  
Hyun-Jung Kim ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Predictive Accuracy ◽  
Specific Antigen ◽  
Significant Proportion ◽  
Multivariate Logistic Regression Analysis ◽  
Health Index ◽  
Free Psa ◽  
Prostate Health Index ◽  
Total Psa ◽  
Prostate Health

Abstract BackgroundWe aimed to evaluate the usefulness of the Beckman Coulter prostate health index (PHI) and compare it with total prostate specific antigen (PSA) and related derivatives in predicting the presence and aggressiveness of prostate cancer (PCa) in the Korean population.MethodsA total of 140 men who underwent their first prostate biopsy for suspected PCa were included in this prospective observational study. The diagnostic performance of total PSA, free PSA, %free PSA, [–2] proPSA (p2PSA), %p2PSA, and PHI in detecting and predicting the aggressiveness of PCa was estimated using the receiver operating characteristic curve (ROC) and logistic multivariate regression analyses.ResultsOf 140 patients, PCa was detected in 63 (45%), and 48 (76.2%) of them had significant cancer with a Gleason score (GS) ≥7. In the whole group, the area under the curve (AUC) for ROC analysis of tPSA, free PSA, %fPSA, p2PSA, %p2PSA, and PHI were 0.63, 0.57, 0.69, 0.69, 0.71, and 0.75, respectively, and the AUC was significantly greater in the PHI group than in the tPSA group (p = 0.005). For PCa with GS ≥7, the AUCs for tPSA, free PSA, %fPSA, p2PSA, %p2PSA, and PHI were 0.62, 0.58, 0.41, 0.79, 0.87, and 0.88, respectively, and the AUC was significantly greater in the PHI group than in the tPSA group (p < 0.001). In the subgroup with tPSA 4–10 ng/mL, both %p2PSA and PHI were strong independent predictors for PCa (p = 0.031, p = 0.027) and significantly improved the predictive accuracy of a base multivariable model including age, tPSA, and %fPSA, using multivariate logistic regression analysis. (p = 0.015, p = 0.010). Additionally, at a cutoff PHI value >33.4, unnecessary biopsy could be avoided in 22.9% (32/140) cases, with no aggressive cancer patients missed.ConclusionThis study shows that %p2PSA and PHI are superior to total PSA and %fPSA in predicting the presence and aggressiveness (GS≥7) of PCa among Korean men. Using PHI, a significant proportion of unnecessary biopsies can be avoided.

scholarly journals The validation results for APhiGT algorithm for clarification of prostate cancer staging before treatment (first step)

2019 ◽  
Vol 15 (2) ◽  
pp. 42-52 ◽  
Author(s):  
N. S. Sergeeva ◽  
T. E. Skachkova ◽  
N. V. Marshutina ◽  
K. M. Nushko ◽  
I. M. Shevchuk ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Gleason Score ◽  
Specific Antigen ◽  
Area Under The Curve ◽  
Cancer Staging ◽  
Health Index ◽  
Free Psa ◽  
Prostate Health Index ◽  
Total Psa ◽  
Prostate Health

Background. We have previously described an algorithm APhiGT (Age, Prostate Health index, Gleason score, TNM stage) for staging of prostate cancer (PC) before treatment. The algorithm was developed by logistic regression on an educational selection (ES) of 337 PC cases. The algorithm includes data about the age of patients, the levels of total prostate-specific antigen (PSA), free PSA, [-2]proPSA and the ranked data of the Gleason score (by biopsy results) and T (by TNM).Objective. Validation of APhiGT on the validation selection (VS) of 83 PC cases was carried out in this work.Materials and methods. ROC analysis was performed in ES and VS.Results and сonclusion. It is established that area under the curve (AUC), characterizing the ability to divide clinically significant subgroups of patients (Gleason score <7 vs. Gleason score ≥7, рТ2 vs. рТ3, localized indolent PC vs. localized aggressive PC) for APhiGT both in ES and VS was significantly higher than AUC for total PSA, %[-2]proPSA in free PSA and prostate health index. At the same time, in all clinical subgroups of patients AUC for VS was lower than AUC for ES, which may be due to a significantly smaller size of VS compared to ES.

Serum proPSA as a marker for reducing repeated prostate biopsy numbers

2017 ◽  
Vol 42 (1) ◽  
Author(s):  
Sema Nur Ayyıldız ◽  
Tevfik Noyan ◽  
Ali Ayyıldız ◽  
Erdal Benli ◽  
Abdullah Çırakoğlu ◽  
...  
Keyword(s):  
Prostate Specific Antigen ◽  
Prostate Biopsy ◽  
Prostate Volume ◽  
Specific Antigen ◽  
Lower Sensitivity ◽  
Health Index ◽  
Prostate Biopsies ◽  
Prostate Health Index ◽  
Total Psa ◽  
Prostate Health

AbstractIntroduction:Prostate specific antigen (PSA) has a lower sensitivity and specifity range of 4–10 ng/mL. We aimed to investigate the effectiveness of pPSA in reducing number of prostate biopsies.Methods:This study enrolled 80 patients aged 50 years or older whom had serum total PSA levels between 4 ng/dL and 10 ng/dL. Age, prostate volume, tPSA, fPSA, pPSA, PSA%, pPSA%, t/pPSA, f/pPSA, p/fPSA, p/tPSA, f/p/tPSA, p/f/tPSA, PSAD, fPSA/PSAD, pPSA/PSAD, (Prostate Health Index) PHI, (t/f/pPSA)/tPSA, and PHI2 (New Prostate Health Index) biopsy results were compared between subjects BPH and PCa.Results:Out of 80 subjects, 23 (29%) had PCa and 57 (71%) had BPH. Prostate volume was 51.65 mL in PCa and 64.85 mL in non-PCa group (p>0.05). The rate of PCa increased as prostate volume was reduced and age increased. fPSA, PSA%, p/f/tPSA, fPSA/PSAD values were significant in favor of respectively; BPH, BPH, PCa and BPH (p<0.05).Discussion:Using prostate health index (PHI) was beneficial for predicting PCa. In addition, using pPSA in formulas such as (PHI2) pPSA/(fPSA*√tPSA), p/f/tPSA, (t/f/pPSA)/tPSA may also be useful. This study suggests that the use of pPSA may have a role in reducing the number of prostate biopsies in differentiating PCa and BPH.

Sign in / Sign up

Export Citation Format

Share Document