Investigation and importance of prostate health index for candidates of prostate biopsy

Investigation and Importance of Prostate Health Index for Candidates of Prostate Biopsy Objective: The aim of the present study was to search the efficiency of prostate health index (PHI) which is calculated simultaneously during ultrasound-guided fine needle prostate biopsy (TRUS-Bx) on diagnosis of prostate cancer. Materials and Methods: The present study included 258 subsequent patients who had TRUS-Bx because of elevated blood levels of PSA in our clinic between August 2014 and March 2016. PSA, sPSA and ProPSA were analyzed in the cases who have suspicion of prostate cancer by digital rectal examination and/or those with elevated serum levels of PSA; and TRUS-Bx was performed. Results: Age average of 258 patients was 63,5 ± 8 (36-91) years and mean PSA level and mean PHI value of those patients were 40,1 ± 194,2 (0,12 – 2170) ng/ml and 118 ± 164,5 (0,41 – 1308) ng/ml, respectively. Pathological examination of TRUS-Bx specimens revealed Adeno cancer in 96 patients, BPH in 140 patients, ASAP in 10 patients, HGPIN in 1 patients, chronic prostatitis in 10 patients and squamous cell carcinoma in 1 patient. The mean PSA of the patients whose TRUS-Bx pathology were adeno cancer was 93,9 ± 311,8 (2,2 – 2170) ng/ml whereas mean PSA levels of those with PBH and mean PSA levels of other patients were 7,5 ± 6,7 (0,3 – 71,1) ng/ml and 12,7 ± 14,5 (0,12 – 60.4) ng/ml, respectively. When the PSA level below 4 was accepted low and at and above 4 were accepted as high, the low PSA group included 10 (31,2%) patients with adeno cancer, 22 (68,8%) patients with BPH; and in the high PSA group, 86 (42,2%) patients were reported as adeno cancer and 118 (57,8%) patients were reported as BPH. When the PSA levels below 4 was accepted low and at and above 4 were accepted as high, sensitivity and specificity of PSA to detect prostate adeno cancer were calculated as 89,6% and 15,7%, respectively. Similarly, when a PHI level below 55 was accepted as low and PHI level at and above 55 were accepted as high, sensitivity sensitivity and specificity of PHI to detect prostate adeno cancer were calculated as 71,9% and 67,9%, respectively. Discussion: Overall, the findings above indicate that specificity of PHI is higher than PSA in terms of prostate cancer detection. Key words: Prostate cancer, prostate needle biopsy, PSA, proPSA, prostate health index