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Prostate Blight and Prostatic Diseases 20, 228-233 (June 2017) | doi:10.1038/pcan.2016.72
J J Tosoian, S C Druskin, D Andreas, P Mullane, M Chappidi, S Joo, K Ghabili, J Agostino, K J Macura, H B Carter, E M Schaeffer, A W Partin, L J Sokoll and A E Ross
Background:
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The Prostate Health Index (phi) outperforms PSA and added PSA derivatives for the analysis of prostate blight (PCa). The appulse of phi testing in the real-world analytic ambience has not been ahead assessed.
Methods:
In a single, large, bookish center, phi was activated in 345 patients presenting for analytic appraisal for PCa. Findings on prostate biopsy (including Grade Group (GG), authentic as GG1: Gleason account (GS) 6, GG2: GS 3 4=7, GG3: GS 4 3=7, GG4: GS 8 and GG5: GS 9–10), alluring resonance imaging (MRI) and abolitionist prostatectomy (RP) were prospectively recorded. Biopsy ante and outcomes were compared with a abreast accomplice that did not abide phi testing (n=1318).
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Results:
Overall, 39% of men with phi testing underwent prostate biopsy. No men with phi<19.6 were diagnosed with PCa, and abandoned three men with phi<27 had blight of GG2. Phi was above to PSA for the anticipation of any PCa (area beneath the receiver operating appropriate ambit (AUC) 0.72 vs 0.47) and GG2 PCa (AUC 0.77 vs 0.53) on prostate biopsy. Amid men ability MRI and phi, no men with phi<27 and PI-RADS3 had GG2 cancer. For those men proceeding to RP, accretion phi was associated with college pathologic GG (P=0.002) and date (P=0.001). Compared with patients who did not abide phi testing, the use of phi was associated with a 9% abridgement in the amount of prostate biopsy (39% vs 48%; P<0.001). Importantly, the abridgement in biopsy amid the phi citizenry was accessory to decreased accident of abrogating (8%) and GG1 (1%) biopsies, admitting the admeasurement of biopsies audition GG2 cancers remained unchanged.
Conclusions:
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In this large, real-time analytic experience, phi outperformed PSA alone, was associated with high-grade PCa, and provided commutual advice to MRI. Incorporation of phi into analytic convenance bargain the amount of accidental biopsies after alteration the abundance of apprehension of higher-grade cancers.
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