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Head-to-Head Comparison of Prostate Health Index and Urinary PCA3 for Predicting Cancer at Initial or Repeat Biopsy

2013; Lippincott Williams & Wilkins; Volume: 190; Issue: 2 Linguagem: Inglês

10.1016/j.juro.2013.02.3184

1527-3792

Vincenzo Scattoni, Massimo Lazzeri, Giovanni Lughezzani, Stefano De Luca, Roberto Passera, Enrico Bollito, Donato Randone, Firas Abdollah, Umberto Capitanio, Alessandro Larcher, Giuliana Lista, Giulio Maria Gadda, Vittorio Bini, Francesco Montorsi, Giorgio Guazzoni,

Statistical Methods in Clinical Trials

No AccessJournal of UrologyAdult Urology1 Aug 2013Head-to-Head Comparison of Prostate Health Index and Urinary PCA3 for Predicting Cancer at Initial or Repeat Biopsy Vincenzo Scattoni, Massimo Lazzeri, Giovanni Lughezzani, Stefano De Luca, Roberto Passera, Enrico Bollito, Donato Randone, Firas Abdollah, Umberto Capitanio, Alessandro Larcher, Giuliana Lista, Giulio Maria Gadda, Vittorio Bini, Francesco Montorsi, and Giorgio Guazzoni Vincenzo ScattoniVincenzo Scattoni Department of Urology, University Vita-Salute, Scientific Institute H San Raffaele, Milan, Italy , Massimo LazzeriMassimo Lazzeri Department of Urology, University Vita-Salute, Scientific Institute H San Raffaele, Milan, Italy , Giovanni LughezzaniGiovanni Lughezzani Department of Urology, University Vita-Salute, Scientific Institute H San Raffaele, Milan, Italy , Stefano De LucaStefano De Luca Department of Urology, Ospedale Gradenigo, Torino, Italy , Roberto PasseraRoberto Passera Department of Urology, Ospedale Gradenigo, Torino, Italy , Enrico BollitoEnrico Bollito Department of Urology, Ospedale Gradenigo, Torino, Italy , Donato RandoneDonato Randone Department of Urology, Ospedale Gradenigo, Torino, Italy , Firas AbdollahFiras Abdollah Department of Urology, University Vita-Salute, Scientific Institute H San Raffaele, Milan, Italy , Umberto CapitanioUmberto Capitanio Department of Urology, University Vita-Salute, Scientific Institute H San Raffaele, Milan, Italy , Alessandro LarcherAlessandro Larcher Department of Urology, University Vita-Salute, Scientific Institute H San Raffaele, Milan, Italy , Giuliana ListaGiuliana Lista Department of Urology, University Vita-Salute, Scientific Institute H San Raffaele, Milan, Italy , Giulio Maria GaddaGiulio Maria Gadda Department of Urology, University Vita-Salute, Scientific Institute H San Raffaele, Milan, Italy , Vittorio BiniVittorio Bini Department of Internal Medicine, University of Perugia, Perugia, Italy , Francesco MontorsiFrancesco Montorsi Department of Urology, University Vita-Salute, Scientific Institute H San Raffaele, Milan, Italy , and Giorgio GuazzoniGiorgio Guazzoni Department of Urology, University Vita-Salute, Scientific Institute H San Raffaele, Milan, Italy View All Author Informationhttps://doi.org/10.1016/j.juro.2013.02.3184AboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract Purpose: We performed a head-to-head comparison of the PHI (Prostate Health Index) and PCA3. Materials and Methods: We evaluated PHI and PCA3 performance in 211 patients undergoing initial (116) or repeat (95) prostate biopsy. Multivariable logistic regression analysis was done using the AUC to test the accuracy of PHI and PCA3 for predicting prostate cancer in the overall population and in each setting. Decision curve analysis was used to compare the clinical benefit of different models. Results: Overall, the AUC of the PHI (0.70) was significantly higher than the AUC of PCA3 (0.59), total prostate specific antigen (0.56) and free-to-total prostate specific antigen (0.60) (p = 0.043, 0.002 and 0.037, respectively). PHI was more accurate than PCA3 for predicting prostate cancer in the initial setting (AUC 0.69 vs 0.57) and in the repeat setting (AUC 0.72 vs 0.63), although no statistically significant difference was observed. Including PCA3 in the base multivariable model (prostate specific antigen plus free-to-total prostate specific antigen plus prostate volume) did not increase predictive accuracy in either setting (AUC 0.79 vs 0.80 and 0.75 vs 0.76, respectively). Conversely, including PHI in the base multivariable model improved predictive accuracy by 5% (AUC 0.79 to 0.84) and 6% (AUC 0.75 to 0.81) in the initial and repeat prostate biopsy settings, respectively. On decision curve analysis the highest net benefit was observed when PHI was added to the base multivariable model. Conclusions: PHI and PCA3 provide a significant increase in sensitivity and specificity compared to all other examined markers and they may help guide biopsy decisions. PCA3 does not increase the accuracy of predicting prostate cancer when PHI is assessed. References 1 : EAU guidelines on prostate cancer. Part 1: screening, diagnosis, and treatment of clinically localised disease. Eur Urol2011; 59: 61. 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Link, Google Scholar © 2013 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetailsCited byTaneja S (2015) Re: Can Urinary PCA3 Supplement PSA in the Early Detection of Prostate Cancer?Journal of Urology, VOL. 194, NO. 1, (115-115), Online publication date: 1-Jul-2015.Fossati N, Lazzeri M and Larcher A (2015) Re: Editorial Comment on Clinical Performance of Serum Isoform -2proPSA (p2PSA) and its Derivatives, Namely %p2PSA and PHI (Prostate Health Index) in Men Younger than 60 Years of Age: Results from a Multicentric European StudyJournal of Urology, VOL. 194, NO. 1, (265-266), Online publication date: 1-Jul-2015.Taneja S (2014) Re: Clinical Performance of Serum Isoform -2proPSA (p2PSA) and its Derivatives, Namely %p2PSA and PHI (Prostate Health Index) in Men Younger than 60 Years of Age: Results from a Multicentric European StudyJournal of Urology, VOL. 192, NO. 2, (421-421), Online publication date: 1-Aug-2014.Porpiglia F, Russo F, Manfredi M, Mele F, Fiori C, Bollito E, Papotti M, Molineris I, Passera R and Regge D (2014) The Roles of Multiparametric Magnetic Resonance Imaging, PCA3 and Prostate Health Index—Which is the Best Predictor of Prostate Cancer after a Negative Biopsy?Journal of Urology, VOL. 192, NO. 1, (60-66), Online publication date: 1-Jul-2014. Volume 190Issue 2August 2013Page: 496-501Supplementary Materials Advertisement Copyright & Permissions© 2013 by American Urological Association Education and Research, Inc.Keywordsprostate-specific antigenprostatic neoplasmsprostate cancer antigen 3, humanbiopsyprostateAcknowledgmentsBeckman Coulter, Italy provided Access Hybritech p2PSA reagents and the Access 2 Immunoassay system.MetricsAuthor Information Vincenzo Scattoni Department of Urology, University Vita-Salute, Scientific Institute H San Raffaele, Milan, Italy More articles by this author Massimo Lazzeri Department of Urology, University Vita-Salute, Scientific Institute H San Raffaele, Milan, Italy Financial interest and/or other relationship with Beckman Coulter. More articles by this author Giovanni Lughezzani Department of Urology, University Vita-Salute, Scientific Institute H San Raffaele, Milan, Italy Financial interest and/or other relationship with Beckman Coulter. More articles by this author Stefano De Luca Department of Urology, Ospedale Gradenigo, Torino, Italy More articles by this author Roberto Passera Department of Urology, Ospedale Gradenigo, Torino, Italy More articles by this author Enrico Bollito Department of Urology, Ospedale Gradenigo, Torino, Italy More articles by this author Donato Randone Department of Urology, Ospedale Gradenigo, Torino, Italy More articles by this author Firas Abdollah Department of Urology, University Vita-Salute, Scientific Institute H San Raffaele, Milan, Italy More articles by this author Umberto Capitanio Department of Urology, University Vita-Salute, Scientific Institute H San Raffaele, Milan, Italy More articles by this author Alessandro Larcher Department of Urology, University Vita-Salute, Scientific Institute H San Raffaele, Milan, Italy More articles by this author Giuliana Lista Department of Urology, University Vita-Salute, Scientific Institute H San Raffaele, Milan, Italy More articles by this author Giulio Maria Gadda Department of Urology, University Vita-Salute, Scientific Institute H San Raffaele, Milan, Italy More articles by this author Vittorio Bini Department of Internal Medicine, University of Perugia, Perugia, Italy More articles by this author Francesco Montorsi Department of Urology, University Vita-Salute, Scientific Institute H San Raffaele, Milan, Italy More articles by this author Giorgio Guazzoni Department of Urology, University Vita-Salute, Scientific Institute H San Raffaele, Milan, Italy More articles by this author Expand All Advertisement PDF downloadLoading ...