J Korean Med Sci.
2018 Mar;33(11):e94. 10.3346/jkms.2018.33.e94.
Diagnostic Performance of %[-2]proPSA and Prostate Health Index for Prostate Cancer: Prospective, Multi-institutional Study
- Affiliations
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- 1Department of Urology, Kangwon National University School of Medicine, Chuncheon, Korea. urodr348@kangwon.ac.kr
- 2Department of Urology, Wonju Christian Hospital, Yonsei University Wonju College of Medicine, Wonju, Korea.
- 3Department of Urology, Gangneung Asan Hospital, University of Ulsan College of Medicine, Gangneung, Korea.
- 4Department of Urology, Hallym University Chuncheon Sacred Heart Hospital, Hallym University College of Medicine, Chuncheon, Korea.
- 5Department of Clinical Diagnosis, Kangwon National University School of Medicine, Chuncheon, Korea.
- KMID: 2405664
- DOI: http://doi.org/10.3346/jkms.2018.33.e94
Abstract
- BACKGROUND
We evaluated the clinical performance of [-2]proPSA (p2PSA) and its derivatives in predicting the presence and aggressiveness of prostate cancer (PCa) in Korean men.
METHODS
A total of 246 men with total prostate-specific antigen (tPSA) ≥ 3.5 ng/mL who underwent their first prostate biopsy were included in this prospective, multicenter, observational study. Diagnostic accuracy of tPSA, free-to-total PSA ratio (%fPSA), p2PSA, %p2PSA, and the Beckman Coulter prostate health index (PHI) was assessed by receiver operating characteristic curve analyses and logistic regression analyses.
RESULTS
Overall, PCa was detected in 125 (50.8%) subjects. In men with tPSA 3.5-10 ng/mL, the detection rate of PCa was 39.4% (61/155). In this group, PHI and %p2PSA were the most accurate predictors of PCa and significantly outperformed tPSA and %fPSA; area under the curve for tPSA, %fPSA, %p2PSA, and PHI was 0.56, 0.69, 0.74, and 0.76, respectively. PHI was also the strongest predictor of PCa with Gleason score ≥ 7.
CONCLUSION
This study demonstrates the superior clinical performance of %p2PSA and PHI in predicting the presence and aggressiveness of PCa in Korean men. The %p2PSA and PHI appear to improve detection of PCa and provide prognostic information.
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