Diagnostic performance of prostate health index (PHI) in predicting prostate cancer on prostate biopsy
- Author:
Hanita Othman
1
Author Information
1. Department of Pathology, Faculty of Medicine, Universiti Kebangsaan Malaysia Medical Centre (UKMMC), Jalan Yaacob Latif, Bandar Tun Razak, 56000 Kuala Lumpur
- Collective Name:Azzah Hana Abu Yamin; Nurismah Md Isa; Badrulhisham Bahadzor; Syed Zulkifli Syed Zakaria
- Publication Type:Journal Article
- Keywords:
Prostate Health Index (PHI);
prostate-specific antigen;
prostate cancer, biopsy
- From:The Malaysian Journal of Pathology
2020;42(2):209-214
- CountryMalaysia
- Language:English
-
Abstract:
Prostate health index (PHI) has been shown to have better diagnostic accuracy in
predicting prostate cancer (PCa) in men with total prostate-specific antigen (PSA) levels between
4-10ng/ml. However, little is known of its value in men with elevated PSA beyond this range. This
study aimed to evaluate the diagnostic performance of PHI in Malaysian men with elevated PSA
values ≤ 20ng/ml. Materials and Methods: From March 2015 to August 2016, all men consecutively
undergoing transrectal ultrasound (TRUS)-guided prostate biopsy with total PSA values ≤ 20ng/
ml were recruited. Blood samples were taken immediately before undergoing prostate biopsy.
The performance of total PSA, %fPSA, %p2PSA and PHI in determining the presence of PCa on
prostate biopsy were compared. Results: PCa was diagnosed in 25 of 84 patients (29.7%). %p2PSA
and PHI values were significantly higher (p<0.05) in patients with PCa than those without PCa.
The areas under the receiver operating characteristic curves for total PSA, %fPSA, %p2PSA and
PHI were 0.558, 0.560, 0.734 and 0.746, respectively. At 90% sensitivity, the specificity of PHI
(42.4%) was five times better than total PSA (8.5%) and two times better than %fPSA (20.3%).
By utilising PHI cut-off >22.52, 27 of 84 (32.1%) patients could have avoided undergoing biopsy.
Conclusion: Findings of our study support the potential clinical effectiveness of PHI in predicting
PCa in a wider concentration range of total PSA up to 20ng/ml.
- Full text:5.2020my01063.pdf
