Aktas Semih, Yücetaş Uğur, Yücetaş Esma, Ates Huseyin Aytac, Genc Cihat, Erkan Erkan
Hamidiye Faculty of Medicine, Istanbul Health Practice and Research Center, Department of Urology, Health Sciences University, Istanbul, 34098, Turkey.
Hamidiye Faculty of Medicine, Haseki Health Practice and Research Center, Department of Biochemistry, Health Sciences University, Istanbul, Turkey.
World J Urol. 2025 Jul 12;43(1):431. doi: 10.1007/s00345-025-05820-0.
To determine the efficacy of the Prostate Health Index (PHI) in predicting pathological progression under an active surveillance protocol in low-risk localized prostate cancer (PC) cases.
Pre-biopsy blood samples were collected from patients who underwent prostate biopsy as part of another study since January 2015, centrifuged, and stored in refrigerators at -20/-80 °C. PHI values were calculated for 77 patients who met active surveillance criteria between January 2015 and January 2022. PHI values in serum samples of groups that showed and did not show progression after control biopsy were compared according to the initial biopsy pathology. The relationship between PHI and pathological progression was evaluated.
A total of 77 patients who met the study criteria were included in the study. Progression was observed in 28 patients during control biopsy, while no progression was observed in 49 patients. In the group showing progression on the first biopsy, the PHI value was 82.06 ± 74.82, while in the group without progression, the PHI value was 50.21 ± 28.18 (p = 0.041). In the group showing progression on the second biopsy, the PHI value was 115.85 ± 109.6, while in the group without progression, the PHI value was 79.29 ± 80.97 (p = 0.005). ROC analysis showed the diagnostic value of PHI values at the time of diagnosis in predicting progression (AUC: 0.641, 95% CI 0.510-0.771, p = 0.034).
Considering the ease of measurement and differences in MP-MRI interpretation, PHI value is a useful, beneficial and highly predictive biomarker for predicting progression in patients under active surveillance, even when used alone.
确定前列腺健康指数（PHI）在预测低风险局限性前列腺癌（PC）病例积极监测方案下病理进展方面的疗效。
自2015年1月起，从作为另一项研究一部分接受前列腺活检的患者中采集活检前血样，离心后储存在-20/-80°C的冰箱中。计算2015年1月至2022年1月期间符合积极监测标准的77例患者的PHI值。根据初次活检病理结果，比较对照活检后出现和未出现进展的组血清样本中的PHI值。评估PHI与病理进展之间的关系。
共有77例符合研究标准的患者纳入研究。对照活检期间，28例患者出现进展，49例患者未出现进展。首次活检显示进展的组中，PHI值为82.06± 74.82，而未进展组中，PHI值为50.21± 28.18（p = 0.041）。第二次活检显示进展的组中，PHI值为115.85± 109.6，而未进展组中，PHI值为79.29± 80.97（p = 0.005）。ROC分析显示诊断时PHI值在预测进展方面的诊断价值（AUC：0.641，95%CI 0.510 - 0.771，p = 0.034）。
考虑到测量的简便性和多参数磁共振成像（MP-MRI）解读的差异，即使单独使用，PHI值也是预测积极监测患者进展的有用、有益且具有高度预测性的生物标志物。
