Unveiling the Role of PHI in Prostate Cancer Diagnosis: Insights from an Indian Population Study
DOI:
https://doi.org/10.51168/sjhrafrica.v5i12.1478Keywords:
PHI, prostate cancer, prostate health index, prostate cancer screening, free PSA, PSA prognosisAbstract
Introduction- The Prostate Health Index (PHI) is based on various Prostate-specific Antigen (PSA) derivatives and has been approved in Europe, Australia, and the United States. PHI outperforms its components for the prediction of overall and high-grade prostate cancer on biopsy. With this study, we aim to find out the utility of PHI in the Indian scenario and its role in the decision-making for biopsy when PSA seems to be in the indecisive range.
Patients and Methods –A total of seventy-five patients with PSA in the range of 4-20ng/ml were enrolled in the study. For each patient, PSA parameters including total PSA, free PSA, and p2PSA were determined from blood samples. PHI was determined using the formula (Beckman Coulter) PHI= (p2PSA/free PSA) x √ PSA. All the patients underwent Trans-rectal ultrasound (TRUS)-guided prostate biopsy. We compared the diagnostic performances of these PSA derivatives to predict carcinoma prostate.
Results- About 53.33% were found to be of benign etiology and 46.67% were of malignant etiology based on the histopathology report of the prostate biopsy. PHI had the highest Area UnderThe Curve (AUC) value of 0.9686, followed by p2PSA (0.9236). At the cut-off value of 35.7 PHI has a sensitivity of 94.28% and a specificity of 90% to detect high-grade malignancy. Using the cut-off value of PHI=35, 46.67% of the prostate biopsies could be prevented.
Conclusion –PHI outperformed PSA in detecting Prostate cancer (PC). Higher value of PHI was connected to high-grade PC. We strongly feel that PHI should be widely available in India.
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