Despite the increasing number of patients was diagnosed with prostate cancer due to widespread cancer screening, PSA testing does not differentiate between lethal and slow-growing inert prostate cancers. This leads to a proportion of patients being over-diagnosed and consequently over-treated.The current study has found that PSA exists as a precursor to post-translational modification, and that [-2]proPSA originates only from the peripheral zone of the prostate. Furthermore, the study has shown that prostate health index (PHI) calculated from [-2]proPSA, fPSA, and PSA has a higher positive predictive value for prostate cancer, making it useful in the diagnosis of clinically significant prostate cancer. This article reviews the progress of research related to PHI in prostate cancer diagnosis and treatment.

Prostate cancer is one of the most frequent malignancies of the urological tract. Surgery, radiotherapy, and immunotherapy are the main treatment methods for prostate cancer, which often lead to unsatisfactory outcomes due to the obvious heterogeneity of the tumor. Recently, poorly differentiated, self-renewing cancer initiation sites and treatment-resistant cancer stem cells (CSC) have become a hot topic in prostate cancer research. Targeting prostate cancer stem cells is a novel and promising therapy. In this article, we review the mechanism of stemness maintenance of CSC, its impact on the tumor microenvironment, and the related research progress in prostate cancer treatment, providing a theoretical basis for the targeted therapy of prostate cancer stem cells.