Prostate health index and prostate cancer gene 3 score but not percent-free Prostate Specific Antigen have a predictive role in differentiating histological prostatitis from PCa and other nonneoplastic lesions (BPH and HG-PIN) at repeat biopsy

Stefano De Luca, Roberto Passera, Cristian Fiori, Enrico Bollito, Susanna Cappia, Roberto Mario Scarpa, Antonino Sottile, Donato Franco Randone, Francesco Porpiglia

Research output: Contribution to journalArticlepeer-review

Abstract

OBJECTIVE: 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).

PATIENTS AND METHODS: 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).

RESULTS: 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

CONCLUSION: 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.

Original languageEnglish
JournalUrologic Oncology
Volume33
Issue number10
DOIs
Publication statusPublished - Oct 1 2015

Keywords

  • Differential diagnosis
  • Percentage of free prostate-specific antigen
  • Prostate cancer
  • Prostate cancer antigen 3 gene
  • Prostate health index
  • Prostate-specific antigen
  • Prostatitis

ASJC Scopus subject areas

  • Oncology
  • Urology

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