The efficacy of prostate health index (PHI) in predicting pathological progression in low-risk localized prostate cancer cases under active surveillance protocol.

Objective: To determine the efficacy of the Prostate Health Index (PHI) in predicting pathological progression under an active surveillance protocol in low-risk localized prostate cancer (PC) cases.

Materials And Methods: Pre-biopsy blood samples were collected from patients who underwent prostate biopsy as part of another study since January 2015, centrifuged, and stored in refrigerators at -20/-80 °C. PHI values ​​were calculated for 77 patients who met active surveillance criteria between January 2015 and January 2022. PHI values ​​in serum samples of groups that showed and did not show progression after control biopsy were compared according to the initial biopsy pathology. The relationship between PHI and pathological progression was evaluated.

Results: A total of 77 patients who met the study criteria were included in the study. Progression was observed in 28 patients during control biopsy, while no progression was observed in 49 patients. In the group showing progression on the first biopsy, the PHI value was 82.06 ± 74.82, while in the group without progression, the PHI value was 50.21 ± 28.18 (p = 0.041). In the group showing progression on the second biopsy, the PHI value was 115.85 ± 109.6, while in the group without progression, the PHI value was 79.29 ± 80.97 (p = 0.005). ROC analysis showed the diagnostic value of PHI values ​​at the time of diagnosis in predicting progression (AUC: 0.641, 95% CI 0.510-0.771, p = 0.034).

Conclusion: Considering the ease of measurement and differences in MP-MRI interpretation, PHI value is a useful, beneficial and highly predictive biomarker for predicting progression in patients under active surveillance, even when used alone.