COMPLETE TITLE: Comparison of prostate cancer gene 3 score, Prostate Health Index and percentage free prostate-specific antigen for differentiating histological inflammation from prostate cancer and other non-neoplastic alterations of the prostate at initial biopsy
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AIM: To determine if prostate cancer gene 3 (PCA3) score, Prostate Health Index (PHI), and percent free prostate-specific antigen (%fPSA) may be used to differentiate prostatitis from prostate cancer (PCa), benign prostatic hyperplasia (BPH) and high-grade prostate intraepithelial neoplasia (HG-PIN) in patients with elevated PSA and negative digital rectal examination (DRE).
PATIENTS AND METHODS: In the present prospective study, 274 patients, undergoing PCA3 score, PHI and %fPSA assessments before initial biopsy, were enrolled. Three multivariate logistic regression models were used to test PCA3 score, PHI and %fPSA as risk factors for prostatitis vs. PCa, vs. BPH, and vs. HG-PIN. All the analyses were performed for the whole patient cohort and for the 'gray zone' of PSA (4-10 ng/ml) cohort (188 individuals).
RESULTS: The determinants for prostatitis vs. PCa were PCA3 score, PHI and %fPSA (Odds Ratio [OR]=0.97, 0.96 and 0.94, respectively). Unit increase of PHI was the only risk factor for prostatitis vs. BPH (OR=1.06), and unit increase of PCA3 score for HG-PIN vs. prostatitis (OR=0.98). In the 'gray zone' PSA cohort, the determinants for prostatitis vs. PCa were PCA3 score, PHI and %fPSA (OR=0.96, 0.94 and 0.92, respectively), PCA3 score and PHI for prostatitis vs. BPH (OR=0.96 and 1.08, respectively), and PCA3 score for prostatitis vs. HG-PIN (OR=0.97).
CONCLUSION: The clinical benefit of using PCA3 score and PHI to estimate prostatitis vs. PCa was comparable; even %fPSA had good diagnostic performance, being a faster and cheaper marker. PHI was the only determinant for prostatitis vs. BPH, while PCA3 score for prostatitis vs. HG-PIN.
De Luca S, Passera R, Bollito E, Manfredi M, Scarpa RM, Sottile A, Randone DF, Porpiglia F. Are you the author?
Division of Urology, San Luigi Gonzaga Hospital and University of Torino, Orbassano, Torino, Italy; Division of Nuclear Medicine, San Giovanni Battista Hospital and University of Torino, Torino, Italy; Division of Pathology, San Luigi Gonzaga Hospital and University of Torino, Orbassano, Torino, Italy; Division of Laboratory Medicine, Candiolo Cancer Institute, Candiolo, Italy; Division of Urology, Gradenigo Hospital, Torino, Italy.
Reference: Anticancer Res. 2014 Dec;34(12):7159-65.