Prostate Health Index (PHI) Predicts High-stage Pathology in African American Men

Zeyad R. Schwen, Jeffrey J. Tosoian, Lori J Sokoll, Leslie Mangold, Elizabeth Humphreys, Edward M. Schaeffer, Alan Wayne Partin, Ashley E. Ross

Research output: Contribution to journalArticle

Abstract

Objective: To evaluate the association between the Prostate Health Index (PHI) and adverse pathology in a cohort of African American (AA) men undergoing radical prostatectomy. Materials and Methods: Eighty AA men with prostate-specific antigen (PSA) of 2-10 ng/mL underwent measurement of PSA, free PSA (fPSA), and p2PSA prior to radical prostatectomy. PHI was calculated as [(p2PSA/fPSA) × (PSA)1/2]. Biomarker association with pT3 disease was assessed using logistic regression, and covariates were added to a baseline multivariable model including digital rectal examination. Biomarker ability to predict pT3 disease was measured using the area under the receiver operator characteristic curve. Results: Sixteen men (20%) demonstrated pT3 disease on final pathology. Mean age, PSA, and %fPSA were similar in men with and without pT3 disease (all P > .05), whereas PHI was significantly greater in men with pT3 disease (mean 57.2 vs 46.6, P = .04). Addition of PHI to the baseline multivariable model improved discriminative ability by 12.9% (P = .04) and yielded greater diagnostic accuracy than models, including other individual biomarkers. Conclusion: In AA men with PSA of 2-10 ng/mL, PHI was predictive of pT3 prostate cancer and may help to identify men at increased risk of adverse pathology. Additional studies are needed to substantiate these findings and identify appropriate thresholds for clinical use.

Original languageEnglish (US)
JournalUrology
DOIs
StateAccepted/In press - Sep 15 2015

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African Americans
Prostate
Prostate-Specific Antigen
Pathology
Health
Biomarkers
Prostatectomy
Digital Rectal Examination
Prostatic Neoplasms
Logistic Models

ASJC Scopus subject areas

  • Urology

Cite this

Schwen, Z. R., Tosoian, J. J., Sokoll, L. J., Mangold, L., Humphreys, E., Schaeffer, E. M., ... Ross, A. E. (Accepted/In press). Prostate Health Index (PHI) Predicts High-stage Pathology in African American Men. Urology. https://doi.org/10.1016/j.urology.2015.12.004

Prostate Health Index (PHI) Predicts High-stage Pathology in African American Men. / Schwen, Zeyad R.; Tosoian, Jeffrey J.; Sokoll, Lori J; Mangold, Leslie; Humphreys, Elizabeth; Schaeffer, Edward M.; Partin, Alan Wayne; Ross, Ashley E.

In: Urology, 15.09.2015.

Research output: Contribution to journalArticle

Schwen, Zeyad R. ; Tosoian, Jeffrey J. ; Sokoll, Lori J ; Mangold, Leslie ; Humphreys, Elizabeth ; Schaeffer, Edward M. ; Partin, Alan Wayne ; Ross, Ashley E. / Prostate Health Index (PHI) Predicts High-stage Pathology in African American Men. In: Urology. 2015.
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abstract = "Objective: To evaluate the association between the Prostate Health Index (PHI) and adverse pathology in a cohort of African American (AA) men undergoing radical prostatectomy. Materials and Methods: Eighty AA men with prostate-specific antigen (PSA) of 2-10 ng/mL underwent measurement of PSA, free PSA (fPSA), and p2PSA prior to radical prostatectomy. PHI was calculated as [(p2PSA/fPSA) × (PSA)1/2]. Biomarker association with pT3 disease was assessed using logistic regression, and covariates were added to a baseline multivariable model including digital rectal examination. Biomarker ability to predict pT3 disease was measured using the area under the receiver operator characteristic curve. Results: Sixteen men (20{\%}) demonstrated pT3 disease on final pathology. Mean age, PSA, and {\%}fPSA were similar in men with and without pT3 disease (all P > .05), whereas PHI was significantly greater in men with pT3 disease (mean 57.2 vs 46.6, P = .04). Addition of PHI to the baseline multivariable model improved discriminative ability by 12.9{\%} (P = .04) and yielded greater diagnostic accuracy than models, including other individual biomarkers. Conclusion: In AA men with PSA of 2-10 ng/mL, PHI was predictive of pT3 prostate cancer and may help to identify men at increased risk of adverse pathology. Additional studies are needed to substantiate these findings and identify appropriate thresholds for clinical use.",
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AU - Schwen, Zeyad R.

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AU - Sokoll, Lori J

AU - Mangold, Leslie

AU - Humphreys, Elizabeth

AU - Schaeffer, Edward M.

AU - Partin, Alan Wayne

AU - Ross, Ashley E.

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N2 - Objective: To evaluate the association between the Prostate Health Index (PHI) and adverse pathology in a cohort of African American (AA) men undergoing radical prostatectomy. Materials and Methods: Eighty AA men with prostate-specific antigen (PSA) of 2-10 ng/mL underwent measurement of PSA, free PSA (fPSA), and p2PSA prior to radical prostatectomy. PHI was calculated as [(p2PSA/fPSA) × (PSA)1/2]. Biomarker association with pT3 disease was assessed using logistic regression, and covariates were added to a baseline multivariable model including digital rectal examination. Biomarker ability to predict pT3 disease was measured using the area under the receiver operator characteristic curve. Results: Sixteen men (20%) demonstrated pT3 disease on final pathology. Mean age, PSA, and %fPSA were similar in men with and without pT3 disease (all P > .05), whereas PHI was significantly greater in men with pT3 disease (mean 57.2 vs 46.6, P = .04). Addition of PHI to the baseline multivariable model improved discriminative ability by 12.9% (P = .04) and yielded greater diagnostic accuracy than models, including other individual biomarkers. Conclusion: In AA men with PSA of 2-10 ng/mL, PHI was predictive of pT3 prostate cancer and may help to identify men at increased risk of adverse pathology. Additional studies are needed to substantiate these findings and identify appropriate thresholds for clinical use.

AB - Objective: To evaluate the association between the Prostate Health Index (PHI) and adverse pathology in a cohort of African American (AA) men undergoing radical prostatectomy. Materials and Methods: Eighty AA men with prostate-specific antigen (PSA) of 2-10 ng/mL underwent measurement of PSA, free PSA (fPSA), and p2PSA prior to radical prostatectomy. PHI was calculated as [(p2PSA/fPSA) × (PSA)1/2]. Biomarker association with pT3 disease was assessed using logistic regression, and covariates were added to a baseline multivariable model including digital rectal examination. Biomarker ability to predict pT3 disease was measured using the area under the receiver operator characteristic curve. Results: Sixteen men (20%) demonstrated pT3 disease on final pathology. Mean age, PSA, and %fPSA were similar in men with and without pT3 disease (all P > .05), whereas PHI was significantly greater in men with pT3 disease (mean 57.2 vs 46.6, P = .04). Addition of PHI to the baseline multivariable model improved discriminative ability by 12.9% (P = .04) and yielded greater diagnostic accuracy than models, including other individual biomarkers. Conclusion: In AA men with PSA of 2-10 ng/mL, PHI was predictive of pT3 prostate cancer and may help to identify men at increased risk of adverse pathology. Additional studies are needed to substantiate these findings and identify appropriate thresholds for clinical use.

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