Marija Barisiene1, Arnas Bakavicius1, Diana Stanciute2,3, Jolita Jurkeviciene4, Arunas Zelvys1, Albertas Ulys1, Dalius Vitkus1, Feliksas Jankevicius1
1Institute of Clinical Medicine, Faculty of Medicine, Vilnius University, Vilnius 03101, Lithuania.
2Laboratory of Molecular Oncology, National Cancer Institute, Vilnius 08660, Lithuania.
3Faculty of Health Sciences, Klaipeda University, Klaipėda 92294, Lithuania.
4Centre of Laboratory Medicine, Vilnius University Hospital Santaros klinikos, Vilnius 08661, Lithuania.
Summary
Purpose: Prostate Health Index (PHI) and %p2PSA have demonstrated more accurate overall and aggressive prostate cancer (PC) detection at prostate biopsy level, however a significant number of PC patients undergo upgrading and upstaging following definitive surgery. The purpose of our study was to evaluate the ability of p2PSA and its derivatives to predict clinically significant PC at final pathology.
Methods: Blood samples from 51 patients, who underwent radical prostatectomy (RP), were collected pre-operatively and tPSA, fPSA, as well as p2PSA values were estimated. %p2PSA, PHI and PHI density (PHID) were calculated according to the relevant formulas. Clinically significant PC was defined as ISUP (International Society of Urological Pathology) grade group ≥2 at final pathology.
Results: Mean value of PHID was significantly higher (1.74 vs. 1.24, p = 0.031) in patients with clinically significant PC at final pathology. At ROC analysis, PHI, PHID and %fPSA were the most accurate predictors of clinically significant disease with AUC of 0.69, 0.70 and 0.76, respectively. PHI has demonstrated the best net benefit in predicting clinically significant PC at RP specimens.
Conclusions: PHI and PHID demonstrate high predicting value of clinically significant PC at final RP pathology and may define more precisely the preoperative diagnosis of this disease.
Key words: clinically significant, diagnostics, prostate cancer, prostate health index, prostate health index density, %p2PSA.
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