dc.contributor.author
Schulze, Anni
dc.contributor.author
Christoph, Frank
dc.contributor.author
Sachs, Markus
dc.contributor.author
Schroeder, Joerg
dc.contributor.author
Stephan, Carsten
dc.contributor.author
Schostak, Martin
dc.contributor.author
Koenig, Frank
dc.date.accessioned
2021-07-08T08:19:44Z
dc.date.available
2021-07-08T08:19:44Z
dc.identifier.uri
https://refubium.fu-berlin.de/handle/fub188/31267
dc.identifier.uri
http://dx.doi.org/10.17169/refubium-31003
dc.description.abstract
Objectives: We investigated the diagnostic efficacy of the prostate health index (PHI) and PHI density (PHID) to avoid unnecessary prostate biopsies in 3 urological practices.
Methods: In 122 patients, total prostate-specific antigen (PSA), free PSA (f-PSA), the quotient from total PSA and f-PSA (f-PSA%), and [-2]pro-PSA were measured in the serum; PHI, PHID, and PSA density (PSAD) were calculated prior to prostate biopsy. Tissue sampling via transrectal biopsy was indicated in case of suspicious PSA (progression and/or elevation of PSA) and/or suspicious digital rectal examination. PSAD, PHI, and PHID were not used for biopsy indication. The diagnostic efficacy was determined with receiver-operating characteristic (ROC)and decision curve analyses.
Results: Based on prostate biopsies, 38% (n = 46) of the cases had no prostate carcinoma (PCa), 21% (n = 26) no clinically significant (insignificant) PCa, and 41% (n = 50) had clinically significant PCa. ROC analyses of the PSA parameters showed higher diagnostic efficacy for PHI and PHID (AUC 0.722 and 0.739) than for f-PSA%, PSA, and PSAD (AUC 0.612, 0.595, and 0.698, respectively) regarding carcinoma diagnosis. With a combined use of PHI and PHID (cutoff >40 and >0.9, respectively), only 1 clinically significant PCa would have been missed (sensitivity 98%); in 24 (20%) patients, biopsy could have been avoided.
Conclusion:The integration of PHI and PHID could improve the diagnostic efficacy of risk calculators to avoid unnecessary prostate biopsies. However, as a prerequisite, validation of cutoff values in prospective studies is urgently required.
en
dc.subject
Prostate health index
en
dc.subject
Prostate health index density
en
dc.subject
Prostate cancer
en
dc.subject
Prostate biopsy
en
dc.subject.ddc
600 Technik, Medizin, angewandte Wissenschaften::610 Medizin und Gesundheit::610 Medizin und Gesundheit
dc.title
Use of the Prostate Health Index and Density in 3 Outpatient Centers to Avoid Unnecessary Prostate Biopsies
dc.type
Wissenschaftlicher Artikel
dcterms.bibliographicCitation.doi
10.1159/000506262
dcterms.bibliographicCitation.journaltitle
Urologia Internationalis
dcterms.bibliographicCitation.number
3-4
dcterms.bibliographicCitation.originalpublishername
Karger
dcterms.bibliographicCitation.pagestart
181
dcterms.bibliographicCitation.pageend
186
dcterms.bibliographicCitation.volume
104
dcterms.rightsHolder.note
Copyright applies in this work.
dcterms.rightsHolder.url
http://rightsstatements.org/vocab/InC/1.0/
refubium.affiliation
Charité - Universitätsmedizin Berlin
refubium.note.author
Dieser Beitrag ist mit Zustimmung des Rechteinhabers aufgrund einer (DFG geförderten) Allianz- bzw. Nationallizenz frei zugänglich.
de
refubium.note.author
This publication is shared with permission of the rights owner and made freely accessible through a DFG (German Research Foundation) funded license at either an alliance or national level.
en
refubium.resourceType.isindependentpub
no
dcterms.accessRights.openaire
open access
dcterms.bibliographicCitation.pmid
32224611
dcterms.isPartOf.issn
0042-1138
dcterms.isPartOf.eissn
1423-0399