評估攝護腺健康指數於偵測攝護腺癌之應用-萬芳醫院初步結果
許軒豪1、李良明1、林克勳1、林雍偉1,2、石宏仁1、蕭志豪1、溫玉清1,2*
臺北醫學大學˙市立萬芳醫院泌尿科1、臺北醫學大學泌尿科2
Evaluation of prostate health index for the Detection of Prostate Cancer-Preliminary results in Wan Fang Hospital
Syuan-Hao Syu1,Liang-Ming Lee1,Ke-Hsun Lin1,Yung-Wei Lin1,2,Hung-Jen Shih1,
Chi-Hao Hsiao1,Yu-Ching Wen1,2*
Department of Urology, Wan Fang Hospital, Taipei Medical University1
Department of Urology, School of Medicine, College of Medicine, Taipei Medical University2
Purpose: Clinically, several methods are used for prostate cancer (PCa) detecting based on prostate specific antigen (PSA). Due to its low specificity, we design this study to evaluate the accuracy of detecting PCa using prostate health index (PHI) over total prostate specific antigen (tPSA).
Materials and Methods: Data was collected from the Joint Clinical Research Center of Taipei Medical University database. All patients underwent transrectal ultrasound biopsy of prostate due to suspicion of PCa including abnormal PSA or digital rectal examination from Jan.01, 2015 to Dec 31, 2017. Patients with report of high-grade prostatic intraepithelial neoplasia (HGPIN) or atypical glands were excluded. Diagnostic accuracy of tPSA, %fPSA, p2PSA, and PHI was assessed by receiver operating characteristic (ROC) curve and logistic regression analyses.
Results: Total 56 patients were collected. The mean age, tPSA, %fPSA, and PHI were 65.7 years old, 13.03ng/ml, 18.18%, and 44.91, respectively. 12 patients were detected of PCa (21.4%). The mean PHI and tPSA in the PCa group were significantly higher than benign group (104.13 vs 28.76, p = 0.001 and 23.93 vs 10.06, p = 0.043), but no significant difference noted in the average %fPSA (17.04 vs 18.49, p = 0.619). The area under the curve (AUC) for PHI, tPSA, and %fPSA was 0.763, 0.566, and 0.502.
Conclusion: PHI was more accurate in detecting PCa than tPSA or %fPSA in this study. More patients should be collected for confirmation of this result.