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Correlation between Gleason score distribution and Prostate Health Index in patients with prostate-specific antigen values of 2.5?10 ng/mL

Investigative and Clinical Urology 2020년 61권 6호 p.582 ~ 587
최중원, 강민용, 성현환, 전황균, 정병창, 서성일, 전성수, 이현무,
소속 상세정보
최중원 ( Choi Joong-Won ) - VHS Medical Center Department of Urology
강민용 ( Kang Min-Yong ) - Sungkyunkwan University School of Medicine Samsung Medical Center Department of Urology
성현환 ( Sung Hyun-Hwan ) - Sungkyunkwan University School of Medicine Samsung Medical Center Department of Urology
전황균 ( Jeon Hwang-Gyun ) - Sungkyunkwan University School of Medicine Samsung Medical Center Department of Urology
정병창 ( Jeong Byong-Chang ) - Sungkyunkwan University School of Medicine Samsung Medical Center Department of Urology
서성일 ( Seo Seong-Il ) - Sungkyunkwan University School of Medicine Samsung Medical Center Department of Urology
전성수 ( Jeon Seong-Soo ) - Sungkyunkwan University School of Medicine Samsung Medical Center Department of Urology
이현무 ( Lee Hyun-Moo ) - Sungkyunkwan University School of Medicine Samsung Medical Center Department of Urology

Abstract


Purpose: To determine the clinical significance and correlation between the Prostate Health Index (PHI) and Gleason score in patients with a prostate-specific antigen (PSA) value of 2.5?10 ng/mL.

Materials and Methods: This retrospective analysis included 114 patients who underwent biopsy after completion of the PHI from November 2018 to July 2019. Various parameters such as PSA, PHI, PSA density, free PSA, p2PSA, and %free PSA were collected, and correlations with biopsy Gleason score and cancer detection rates were investigated.

Results: Baseline characteristics were comparable between PHI groups (0?26.9 [n=11], 27.0?35.9 [n=17], 36.0?54.9 [n=50], and ≥55.0 [n=36]). A total of 37 patients (32.5%) were diagnosed with prostate cancer, and 28 (24.6%) were diagnosed with clinically significant prostate cancer (CSPC, Gleason score ≥7) after prostate biopsy. The cancer detection rate gradually increased with a corresponding increase in the PHI (18%, 24%, 30%, and 44%, respectively). The same pattern was observed with detecting CSPC (0%, 18%, 26%, and 33%, respectively). There was no CSPC in the groups with PHI <27.0, and Gleason score 7 began to appear in groups with PHI ≥27.0. In particular, patients with Gleason score 8 and 9 were distributed only in the groups with PHI ≥36.0.

Conclusions: The diagnostic accuracy of detection of CSPC could be increased when prostate biopsy is performed in patients with a PHI ≥36.0. In this study, there was a clear Gleason score difference when the PHI cutoff value was set to 27.0 or 36.0.

키워드

Biomarkers; Diagnosis; Prostate neoplasms; Prostate-specific antigen

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