World J Mens Health.  2024 Jan;42(1):168-177. 10.5534/wjmh.220223.

Nomogram Using Prostate Health Index for Predicting Prostate Cancer in the Gray Zone: Prospective, Multicenter Study

• Chung JH
• Kim JH
• Lee SW
• Park H
• Song G
• Song W
• Kang M
• Sung HH
• Jeon HG
• Jeong BC
• Seo SI
• Lee HM
• Jeon SS

• KMID: 2549711
• DOI: http://doi.org/10.5534/wjmh.220223

Abstract

Purpose
To create a nomogram that can predict the probability of prostate cancer using prostate health index (PHI) and clinical parameters of patients. And the optimal cut-off value of PHI for prostate cancer was also assessed.
Materials and Methods
A prospective, multi-center study was conducted. PHI was evaluated prior to biopsy in patients requiring prostate biopsy due to high prostate-specific antigen (PSA). Among screened 1,010 patients, 626 patients with clinically suspected prostate cancer with aged 40 to 85 years, and with PSA levels ranging from 2.5 to 10 ng/mL were analyzed.
Results
Among 626 patients, 38.82% (243/626) and 22.52% (141/626) were diagnosed with prostate cancer and clinically significant prostate cancer, respectively. In the PSA 2.5 to 4 ng/mL group, the areas under the curve (AUCs) of the nomograms for overall prostate cancer and clinically significant prostate cancer were 0.796 (0.727–0.866; p<0.001), and 0.697 (0.598–0.795; p=0.001), respectively. In the PSA 4 to 10 ng/mL group, the AUCs of nomograms for overall prostate cancer and clinically significant prostate cancer were 0.812 (0.783–0.842; p<0.001), and 0.839 (0.810–0.869; p<0.001), respectively.
Conclusions
Even though external validations are necessary, a nomogram using PHI might improve the prediction of prostate cancer, reducing the need for prostate biopsies.

Keyword

Diagnosis; Nomogram; Prostate cancer; Risk