Experience with the prostate health index in daily clinical practice

Czech version

Authors: Vojtěch Fiala; Roman Sobotka; Zuzana Vaľová; Michal Pešl; Tomáš Hradec; Tomáš Hanuš; Otakar Čapoun
Authors‘ workplace: Urologická klinika VFN a 1. LF UK v Praze
Published in: Ces Urol 2017; 21(4): 284-288
Category: Original Articles

Overview

Aim:
The use of prostate health index (PHI) for prostate cancer (PCa) diagnosis in patients with elevated prostate-specific antigen (PSA) level.

Methods:
Between 05/2015 and 05/2016 we performed 230 PHI examinations. We recorded age, PSA and free to total PSA ratio (f/tPSA) before the indication of PHI, PSA, f/tPSA and [-2]proPSA level measured in PHI calculation, size of the prostate, digital rectal examination finding and histology result in case of a prostate biopsy (PB). The distribution of parameters in different groups and subgroups was assessed by nonparametric tests and their correlation by Spearman’s correlation coefficient.

Results:
Median of age was 66 years (60–71). Median PSA level before indication of PHI was 6.1 ng/ml (4.1–9.4). Median of phi was 34.9 (26.7–48.2). Median prostate size was 40 ml (28–60 ml). Information about follow up after PHI measurement was available in 217 (94.4 %) patients until 01/2017. Repeated examination of PSA or phi only was indicated in 134 (61.8 %) cases. Prostate biopsy was indicated in 71 (32.7 %) men and cancer was found in 23 (32.4 %) patients. Only the phi result was not related to the size of prostate (p=0.4708). From laboratory parameters were significant for prediction of PB only fPSA/PSA ratio measured before phi count (p=0.0217) and phi density (0.0209). The phi result was significantly higher in patients indicated to PB (mean 71.3 vs. 29.6; p=0.001)

Conclusion:
The use of PHI in daily clinical practice improves indication of rebiopsy. PHI to prostate size ratio is the best predictor of PCa diagnosis in rebiopsy.

Key words:
Clinical practice, prostate biopsy, prostate cancer, prostate health index, prostate specific antigen.

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