To determine if prostate health index (PHI), prostate cancer antigen gene 3 (PCA3) score, and percentage of free prostate-specific antigen (%fPSA) may be used to differentiate asymptomatic acute and chronic prostatitis from prostate cancer (PCa), benign prostatic hyperplasia (BPH), and high-grade prostate intraepithelial neoplasia (HG-PIN) in patients with elevated PSA levels and negative findings on digital rectal examination at repeat biopsy (re-Bx).
In this prospective study, 252 patients were enrolled, undergoing PHI, PCA3 score, and %fPSA assessments before re-Bx We used 3 multivariate logistic regression models to test the PHI, PCA3 score, 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 (4-10ng/ml) cohort (171 individuals)
Of the 252 patients, 43 (17 1%) had diagnosis of PCa The median PHI was significantly different between men with a negative biopsy and those with a positive biopsy (34 9 vs 48 1, P
In front of a good diagnostic performance of all the 3 biomarkers in distinguishing negative biopsy vs positive biopsy, the clinical benefit of using the PCA3 score and PHI to estimate prostatitis vs PCa was comparable PHI was the only determinant for prostatitis vs BPH, whereas no biomarkers could differentiate prostate inflammation from HG-PIN
Urologic oncology 2015 Jul 07 [Epub ahead of print]
Stefano De Luca, Roberto Passera, Cristian Fiori, Enrico Bollito, Susanna Cappia, Roberto Mario Scarpa, Antonino Sottile, Donato Franco Randone, Francesco Porpiglia
Division of Urology, San Luigi Gonzaga Hospital and University of Torino, Orbassano, Italy , Division of Nuclear Medicine, San Giovanni Battista Hospital and University of Torino, Italy Electronic address: rpassera@cittadellasalute to it , Division of Urology, San Luigi Gonzaga Hospital and University of Torino, Orbassano, Italy , Division of Pathology, San Luigi Gonzaga Hospital and University of Torino, Orbassano, Italy , Division of Pathology, San Luigi Gonzaga Hospital and University of Torino, Orbassano, Italy , Division of Urology, San Luigi Gonzaga Hospital and University of Torino, Orbassano, Italy , Division of Laboratory Medicine, Candiolo Cancer Institute, Candiolo, Italy , Division of Urology, Gradenigo Hospital, Torino, Italy , Division of Urology, San Luigi Gonzaga Hospital and University of Torino, Orbassano, Italy