Department of Urology, VHS Medical Center, Seoul, Korea.
Department of Urology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
Investig Clin Urol. 2020 Nov;61(6):582-587. doi: 10.4111/icu.20200084.
To determine the clinical significance and correlation between the Prostate Health Index (PHI) and Gleason score in patients with a prostate-specific antigen (PSA) value of 2.5-10 ng/mL.
This retrospective analysis included 114 patients who underwent biopsy after completion of the PHI from November 2018 to July 2019. Various parameters such as PSA, PHI, PSA density, free PSA, p2PSA, and %free PSA were collected, and correlations with biopsy Gleason score and cancer detection rates were investigated.
Baseline characteristics were comparable between PHI groups (0-26.9 [n=11], 27.0-35.9 [n=17], 36.0-54.9 [n=50], and ≥55.0 [n=36]). A total of 37 patients (32.5%) were diagnosed with prostate cancer, and 28 (24.6%) were diagnosed with clinically significant prostate cancer (CSPC, Gleason score ≥7) after prostate biopsy. The cancer detection rate gradually increased with a corresponding increase in the PHI (18%, 24%, 30%, and 44%, respectively). The same pattern was observed with detecting CSPC (0%, 18%, 26%, and 33%, respectively). There was no CSPC in the groups with PHI <27.0, and Gleason score 7 began to appear in groups with PHI ≥27.0. In particular, patients with Gleason score 8 and 9 were distributed only in the groups with PHI ≥36.0.
The diagnostic accuracy of detection of CSPC could be increased when prostate biopsy is performed in patients with a PHI ≥36.0. In this study, there was a clear Gleason score difference when the PHI cutoff value was set to 27.0 or 36.0.
确定前列腺特异性抗原（PSA）值为 2.5-10ng/ml 的患者中前列腺健康指数（PHI）与 Gleason 评分之间的临床意义和相关性。
本回顾性分析纳入了 2018 年 11 月至 2019 年 7 月期间完成 PHI 后接受活检的 114 例患者。收集了 PSA、PHI、PSA 密度、游离 PSA、p2PSA 和 %游离 PSA 等各种参数，并研究了与活检 Gleason 评分和癌症检出率的相关性。
PHI 组（0-26.9[11 例]、27.0-35.9[17 例]、36.0-54.9[50 例]和≥55.0[36 例]）的基线特征相似。共有 37 例（32.5%）被诊断为前列腺癌，28 例（24.6%）被诊断为临床显著前列腺癌（CSPC，Gleason 评分≥7）。随着 PHI 的升高，癌症检出率逐渐升高（分别为 18%、24%、30%和 44%）。CSPC 的检出模式相同（分别为 0%、18%、26%和 33%）。在 PHI<27.0 的组中没有 CSPC，而 PHI≥27.0 的组中开始出现 Gleason 评分 7。特别是，Gleason 评分 8 和 9 的患者仅分布在 PHI≥36.0 的组中。
当 PHI≥36.0 时进行前列腺活检，可以提高 CSPC 的检出率。在本研究中，当 PHI 截断值设定为 27.0 或 36.0 时，Gleason 评分有明显差异。
