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

Stefano De Luca, Roberto Passera, Enrico Bollito, Matteo Manfredi, Roberto Mario Scarpa, Antonino Sottile, Donato Franco Randone, Francesco Porpiglia

Research output: Contribution to journalArticle

Abstract

Aim: To determine if prostate cancer gene 3 (PCA3) score, Prostate Health Index (PHI), and percent free prostatespecific 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.

Original languageEnglish
Pages (from-to)7159-7165
Number of pages7
JournalAnticancer Research
Volume34
Issue number12
Publication statusPublished - Dec 1 2014

Keywords

  • Differential diagnosis
  • Percentage free prostatespecific antigen
  • Prostate cancer
  • Prostate cancer antigen 3 gene
  • Prostate Health Index
  • Prostate-specific antigen
  • Prostatitis

ASJC Scopus subject areas

  • Cancer Research
  • Oncology
  • Medicine(all)

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