한국인에서 전립선암을 예측하는 데 있어 Prostate Health Index Density의 임상적 유용성에 관한 전향적, 다기관 연구
Potential Utility of Prostate Health Index Density for Prostate Cancer Detection and Prediction in Korean Men: A Prospective Multicenter Study
송기현, 박홍주, 이상욱, 강태욱, 정재흥, 정현철, 김성진, 박종연, 김정현,
소속 상세정보
송기현 ( Song Gee-Hyun )
Kangwon National University School of Medicine Department of Urology
박홍주 ( Park Hong-Zoo )
Kangwon National University School of Medicine Department of Urology
이상욱 ( Lee Sang-Wook )
Kangwon National University School of Medicine Department of Urology
강태욱 ( Kang Tae-Wook )
Yonsei University Wonju College of Medicine Wonju Christian Hospital Department of Urology
정재흥 ( Jung Jae-Hung )
Yonsei University Wonju College of Medicine Wonju Christian Hospital Department of Urology
정현철 ( Chung Hyun-Chul )
Yonsei University Wonju College of Medicine Wonju Christian Hospital Department of Urology
김성진 ( Kim Sung-Jin )
University of Ulsan College of Medicine Gangneung Asan Hospital Department of Urology
박종연 ( Park Jong-Yeon )
University of Ulsan College of Medicine Gangneung Asan Hospital Department of Urology
김정현 ( Kim Jeong-Hyun )
Kangwon National University School of Medicine Department of Urology
Abstract
Purpose: We evaluated the clinical performance of Prostate Health Index (PHI) density with [-2]proPSA (p2PSA) and its derivatives in predicting the presence of prostate cancer (PCa) in Korean men.
Materials and Methods: A total of 706 men with total prostate-specific antigen (tPSA)≥2.5 ng/mL who underwent their first prostate biopsy were included in this prospective, multicenter, observational study. Diagnostic accuracy of tPSA, free-to-total PSA ratio (%fPSA), p2PSA, %p2PSA, the Beckman Coulter PHI, and PHI density was assessed by receiver operating characteristic curve analyses and logistic regression analyses. PHI was calculated as [(p2PSA/free PSA)×tPSA½], and density calculations were performed using prostate volume as determined by transrectal ultrasonography.
Results: Overall, PCa was detected in 367 of all subjects (52%). In men with tPSA 2.5?10 ng/mL, the detection rate of PCa was 41.1% (188 of 457). In this group, PHI and PHI density were the most accurate predictors of PCa and significantly outperformed tPSA and %fPSA; area under the curve for tPSA, %fPSA, %p2PSA, PHI, and PHI density was 0.58, 0.68, 0.70, 0.75, 0.73 respectively. PHI and PHI density were also the strongest predictor of PCa with Gleason score ≥7.
Conclusions: Based on the present prospective multicenter experience, PHI and PHI density demonstrate the superior clinical performance in predicting the presence of PCa in Korean men with tPSA 2.5?10 ng/mL.
키워드
Biomarkers; Biopsy; Early diagnosis;; Prostatic cancer; Prostate-specific antigen; Protein isoforms
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