Performance of Prostate Health Index in Biopsy Naïve Black Men
| Autor: | Edward M. Schaeffer, Courtney M.P. Hollowell, Rilwan Babajide, Adam B. Murphy, Alfreda Holloway-Beth, Daniel P. Dalton, Oluwarotimi Nettey, Samuel Carbunaru, Tiffany McDowell, Karriem S. Watson, Peter H. Gann, Josef Ben Levi, James Stinson, Le’Andre Moore, Marcus Murray, Rick A. Kittles |
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| Rok vydání: | 2021 |
| Předmět: |
Adult
Male Oncology medicine.medical_specialty Biopsy Urology Comparative effectiveness research 030232 urology & nephrology Unnecessary Procedures urologic and male genital diseases Gleason grade Sensitivity and Specificity Article 03 medical and health sciences Health index Prostate cancer 0302 clinical medicine Prostate Internal medicine Biomarkers Tumor medicine Humans Aged Chicago medicine.diagnostic_test business.industry Prostatic Neoplasms Middle Aged Prostate-Specific Antigen medicine.disease Black or African American medicine.anatomical_structure Case-Control Studies Neoplasm Grading business |
| Zdroj: | J Urol |
| ISSN: | 1527-3792 0022-5347 |
| DOI: | 10.1097/ju.0000000000001453 |
| Popis: | PURPOSE: The Prostate Health Index is validated for prostate cancer detection but has not been well validated for Gleason grade group 2-5 prostate cancer detection in Black men. We hypothesize that the Prostate Health Index has greater accuracy than prostate specific antigen for detection of Gleason grade group 2-5 prostate cancer. We estimated probability of overall and Gleason grade group 2-5 prostate cancer across previously established Prostate Health Index ranges and identified Prostate Health Index cutoffs that maximize specificity for Gleason grade group 2-5 prostate cancer with sensitivity >90%. MATERIALS AND METHODS: We recruited a “cancer-free” Black control cohort (135 patients) and a cohort of biopsy naïve Black men (158) biopsied for elevated prostate specific antigen. Descriptive statistics compared the prostate cancer cases and controls and the frequency of Gleason grade group 2-5 prostate cancer across Prostate Health Index scores. Receiver operating characteristics compared the discrimination of prostate specific antigen, Prostate Health Index and other prostate specific antigen related biomarkers. Sensitivity and specificity for Gleason grade group 2-5 prostate cancer detection were assessed at prostate specific antigen and Prostate Health Index thresholds alone and in series. RESULTS: Of biopsied subjects 32.9% had Gleason grade group 2-5 prostate cancer. In Blacks with prostate specific antigen from 4.0–10.0 ng/ml, Prostate Health Index and prostate specific antigen had similar discrimination for Gleason grade group 2-5 prostate cancer (0.63 vs 0.57, p=0.27). In Blacks with prostate specific antigen ≤10.0, a threshold of prostate specific antigen ≥4.0 had 90.4% sensitivity for Gleason grade group 2-5 prostate cancer; a threshold of prostate specific antigen ≥4.0 with Prostate Health Index ≥35.0 in series avoided unnecessary biopsy in 33.0% of men but missed 17.3% of Gleason grade group 2-5 prostate cancer. Prostate specific antigen ≥4.0 with Prostate Health Index ≥28.0 in series spared biopsy in 17.9%, while maintaining 90.4% sensitivity of Gleason grade group 2-5 prostate cancer. CONCLUSIONS: The Prostate Health Index has moderate accuracy in detecting Gleason grade group 2-5 prostate cancer in Blacks, but Prostate Health Index ≥28.0 can be safely used to avoid some unnecessary biopsies in Blacks. |
| Databáze: | OpenAIRE |
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