MP01: Prostate health index density for prostate cancer detection in taiwanese patients underwent transrectal ultrasound prostate biopsy
  • 2019-01-03,
  • 上傳者: TUA秘書處,
  •  0
潘柏勳1、林子平1,2、范玉華1,2 、魏子鈞1,2、黃奕燊1,2、林志杰1,2、黃逸修1,2、鍾孝仁1,2、郭俊逸1,2、吳宏豪1,2、盧星華1,2、黃志賢1,2、張延驊1,2、林登龍1,2
1台北榮民總醫院 泌尿部; 2陽明大學醫學院泌尿學科及書田泌尿學研究中心
Prostate Health Index Density for prostate cancer detection in Taiwanese patients underwent transrectal ultrasound prostate biopsy
Po-Hsun Pan1, Tzu-Ping Lin1,2, Yu-Hua Fan1,2, Tzu-Chun Wei1,2, Yi-Shen Huang1,2, Chi-Cheh Lin1,2, Eric Y.H. Huang1,2, Hsiao-Jen Chung1,2, Junne-Yih Kuo1,2, Howard H.H. Wu1,2, Shing-Hwa Lu1,2, Yen-Hwa Chang1,2, Alex T.L. Lin1,2, William J.S. Huang1,2
1Department of Urology, Taipei Veterans General Hospital;
2 Department of Urology, School of Medicine, and Shu-Tien Urological Institute,
National Yang-Ming University, Taipei, Taiwan
Purpose: Though prostate-specific antigen (PSA) is used as serum marker for prostate cancer prediction and tracing after treatment, poor cancer specificity has been criticized. Prostate health index (PHI) was newly invented and was proved to have better predictive power then other markers. Due to the inspiration of PSA density (PSAD), PHI density (PHID) which defined as PHI/prostate volume and PHIDD that we created as PHI/√prostate volume were checked if they are superior to other serum markers.
Materials and Methods: This is a prospective study started from March 2017 to August 2018. We enrolled patient who was suspected to have prostate cancer with total PSA > 4.0 ng/ml or having abnormal digital rectal examination findings. These patients were admitted for transrectal ultrasound (TRUS) guided prostate biopsy. Before the procedure, blood was drawn and checked serum total PSA (tPSA), free PSA (fPSA), and p2PSA. PHI, PHID, PHIDD were calculated by the formula of  (p2PSA/free PSA) × √total PSA, PHI/prostate volume and PHI/√prostate volume.
Results: 525 Patients were enrolled in this study which median age was 69 years old. 323 (61.5%) patients were diagnosed to have prostate cancer by TRUS prostate biopsy. All markers has statistically significant difference between cancer and non-cancer group which tPSA, PSAD, p2PSA, p2PSA% PHI, PHID and PHIDD were higher in cancer patients; fPSA% and prostate volume are lower in cancer patients. ROC curve revealed PHIDD has the best AUC (0.786). The other AUCs are PSAD (0.724), p2PSA (0.680), p2PSA% (0.721), PHI (0.780), PHID (0.764). However, PHI can avoid more unnecessary biopsies (31.8%). In multivariate analysis, PHI has the highest odds ratio (7.61, 95% Cl: 4.57-12.70, p<0.001)
Conclusions: PHI has good accuracy for prostate cancer screening, and could avoid unnecessary biopsies and over treatment. But add volume for adjustment and calculate PHIDD can improved the screening power of PHI in patient underwent TRUS biopsy.
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    2019-01-03 14:29:54
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