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PHI density prospectively improves prostate cancer detection.

Carsten Stephan1,2, Klaus Jung3,4, Michael Lein5

  • 1Department of Urology, Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Charitéplatz 1, 10117, Berlin, Germany. carsten.stephan@charite.de.

World Journal of Urology
|January 20, 2021
PubMed
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This summary is machine-generated.

Prostate Health Index density (PHID) shows improved accuracy over Prostate Health Index (PHI) for detecting any prostate cancer (PCa). However, both markers perform equally in identifying significant PCa.

Area of Science:

  • Urology
  • Oncology
  • Biomarker Research

Background:

  • Prostate cancer (PCa) diagnosis often relies on prostate-specific antigen (PSA) and imaging.
  • The Prostate Health Index (PHI) improves diagnostic accuracy over PSA alone.
  • Prostate Health Index density (PHID) is a novel metric potentially enhancing PCa detection.

Purpose of the Study:

  • To prospectively compare the diagnostic performance of PHID against PHI in a large cohort.
  • To evaluate PHID's utility in detecting any prostate cancer and significant prostate cancer.

Main Methods:

  • PHID was calculated using PSA, free PSA, [-2]proPSA, and prostate volume.
  • A cohort of 1057 men (552 with PCa, 505 without) underwent biopsies.
  • Diagnostic accuracy was assessed using receiver operating characteristic (ROC) curves and decision curve analysis (DCA).
Keywords:
Decision curve analysis (DCA)PHI density (PHID)Prostate cancerProstate health index (PHI)

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Main Results:

  • PHID demonstrated a significantly larger area under the ROC curve (AUC) than PHI (0.835 vs. 0.801; p=0.0013).
  • PHID showed superior performance in the PSA grey-zone (up to 8 ng/ml) compared to PHI (AUC 0.819 vs. 0.789; p=0.0219).
  • No significant difference was found between PHID and PHI in detecting significant PCa.

Conclusions:

  • PHID offers an advantage over PHI for detecting any prostate cancer.
  • PHI and PHID exhibit comparable performance in identifying significant prostate cancer.
  • PHID may aid in refining prostate cancer diagnosis, particularly in borderline PSA cases.