Filella Xavier, Foj Laura, Augé Josep Maria, Molina Rafael, Alcover Joan
Clin Chem Lab Med. 2014 Sep;52(9):1347-55. doi: 10.1515/cclm-2014-0027.
%p2PSA and prostate health index (phi) has shown valuable results in the detection of prostate cancer (PCa), improving the prediction of the aggressiveness of the tumor. The goal of the present study was to evaluate %p2PSA and phi in the detection of PCa, estimating their relationship with the aggressiveness of PCa.
A total of 354 patients with positive or negative prostatic biopsy were included. Prospectively, 150 were enrolled and 204 were enrolled retrospectively proceeding from our serum bank.
The best performance was observed for %p2PSA and phi, obtaining an AUC of 0.723 and 0.732, respectively. The highest specificity at sensitivity around 90% was obtained for phi (27.4%). Using the cut-off of 31.94 for phi, a reduction of 19% biopsies could be obtained, while 17 PCa would have been missed, including only four patients with a Gleason score ≥7. Similarly, using a cut-off of 1.21 for %p2PSA, a reduction of 12.7% biopsies could be obtained, while 16 PCa would have been missed, including only four patients with a Gleason score ≥7. Moreover, among patients with PCa, phi (median: 69.75 vs. 48.04) and %p2PSA (median: 2.60 vs. 1.98) values are significantly higher (p<0.0001) in patients with a biopsy Gleason score ≥7.
Our results confirm previous evaluations, showing similar AUCs and results in sensitivity and specificity to other studies.%p2PSA and phi raise the accuracy in the detection of prostate cancer, reducing the number of unnecessary biopsies and improving the prediction of the aggressiveness of the tumor.
%p2PSA和前列腺健康指数（phi）在前列腺癌（PCa）检测中已显示出有价值的结果，有助于改善对肿瘤侵袭性的预测。本研究的目的是评估%p2PSA和phi在PCa检测中的作用，并估计它们与PCa侵袭性的关系。
共纳入354例前列腺活检结果为阳性或阴性的患者。前瞻性纳入150例，回顾性纳入204例，这些患者来自我们的血清库。
%p2PSA和phi表现最佳，其曲线下面积（AUC）分别为0.723和0.732。phi在灵敏度约为90%时获得最高特异性（27.4%）。使用phi的截断值31.94，可减少19%的活检，同时会漏诊17例PCa，其中只有4例患者的Gleason评分≥7。同样，使用%p2PSA的截断值1.21，可减少12.7%的活检，同时会漏诊16例PCa，其中只有4例患者的Gleason评分≥7。此外，在PCa患者中，活检Gleason评分≥7的患者的phi值（中位数：69.75 vs. 48.04）和%p2PSA值（中位数：2.60 vs. 1.98）显著更高（p<0.0001）。
我们的结果证实了先前的评估，显示出与其他研究相似的AUC以及灵敏度和特异性结果。%p2PSA和phi提高了前列腺癌检测的准确性，减少了不必要的活检数量，并改善了对肿瘤侵袭性的预测。
