COMPARISON OF %PRO2 PSA AND PROSTATE HEALTH INDEX FOR DETECTION OF PROSTATE CANCER, A SINGLE CENTER STUDY. WHO IS A BETTER PREDICTOR?

Toni Krstev; Ivica Stojanoski; Gordana Oranska; Biljana Trpkovska; Ateme Karce

Toni Krstev Department of Urology, City General Hospital 8th of September, Skopje, North Macedonia
Ivica Stojanoski Department of Urology, City General Hospital 8th of September Skopje, North Macedonia.
Gordana Oranska University Clinic for Surgical Diseases “St. Naum Ohridski”, Skopje, North Macedonia
Biljana Trpkovska Institute of Anatomy, Faculty of Medicine, St. Cyril and Methodius, Skopje, North Macedonia
Ateme Karce General Hospital Struga, North Macedonia

Abstract

Measurement of serum prostate-specific antigen (PSA) for the detection of prostate cancer has poor specificity in men with PSA levels between 4 and 10 ng/ml. It has been suggested that measurement of the pro2PSA, %pro2PSA and PHI might offer an improvement. We performed a systematic review and meta-analysis to evaluate the diagnostic presentation of these tests among men with PSA levels between 4 and 10 ng/ml in the „gray zone“. We examined 100 men age 50 years or older with prostate specific antigen 4 to 10 ng/ml in the „gray zone“ and normal digital rectal examination with suspected prostate cancer who had undergone biopsies and were divided into a benign and malignant group. In this population we compared the performance of prostate specific antigen (PSA), %p2PSA and PHI to predict prostate cancer and specifically, the presence of clinically significant prostate cancer (csPCa) using multiple criteria.We found statistically significantly increased levels of %pro2PSA, and PHI compared to PSA in patients diagnosed with prostate cancer by prostate biopsy vs. patients with benign prostatic conditions . Conclusions: Both PHI and %p2PSA significantly increased the diagnostic accuracy than PSA as a biomarker. But, PHI is a slightly better predictor in comparison to %p2PSA for the identification of clinically significant prostate cancer and may help to reduce unnecessary prostate biopsies.

Keywords: PHI; %p2PSA, prostate cancer, identification of csPCa, prostate biopsy

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