Prostate health index is useful for prostate cancer detecting in Chinese people

Yuhua Huang, Xiaolei Gu, Yu Wang, Jianquan Hou, Xiaofei Qi


Background: Prostate cancer (PCa) incidence was increased substantially in the last two decades in China. We evaluated the performance of prostate health index (PHI) in predicting the presence of PCa in Chinese people.
Methods: A total of 108 consecutive patients were recruited to develop a PHI-based nomogram to predict PCa. Serum total prostate specific antigen (tPSA), free PSA (fPSA), and p2PSA were measured by Beckman Coulter’s DxI 800 Immunoassay System. PHI was calculated by [p2PSA/fPSA]×. Performance of individual PSA and PHI measurements in discriminating clinical outcomes was measured using the detection rate of PCa, sensitivity, specificity, and area under the receiver operating characteristic curve (AUC).
Results: Among all patients, PHI was a better predictor of PCa compared with tPSA. PHI achieved the highest AUC of 76.6% in discriminating PCa from non-PCa compare to tPSA measurement, the difference of AUC area between PHI and PSA was about 6% in the entire cohort. The PHI-based nomogram reduced the number of biopsies. With the cutoff value (tPSA >4 ng/mL, PHI >40), there were 37 patients need to do biopsies in tPSA >4 ng/mL group, while with PHI >40, only 30 patients need to do. Seven patients could avoid unnecessary biopsies. When combined with the two values (tPSA >4 ng/mL, PHI >40) only 24 patients remained.
Conclusions: Our finding has implication PHI and provides added value over tPSA for PCa detecting in Chinese people.