Prostate health index versus free/total PSA for prostate cancer detection in patients with PSA levels in "gray area" : a systematic analysis

doi:10.3877/cma.j.issn.1674-3253.2021.06.007

Abstract

Abstract:

Objective

To investigate the value of prostate health index and free/total PSA(f/tPSA) of prostate cancer detection in patients with PSA levels between 2-10 ng/ml "gray area" .

Methods

Relevant articles in 5 online databases Pubmed, Embase, Cochrane library, CNKI, VIP were enrolled. Systematic analysis was performed by MetaDisc 1.4, STATA 11.0.

Results

12 articles and 4 639 patients were included in present analysis. As a result, a total of 1 703 patients was confirmed prostate cancer, number of patients with negative prostate biopsies was 2 936. The pooled sensitivity of PHI and f/tPSA were 0.87(95%CI:0.85-0.89) vs 0.86(95%CI:0.84-0.87), respectively, the pooled specificity of PHI and %fPSA were 0.42 (95%CI:0.40-0.44) vs 0.24(95%CI:0.22-0.25). The ROC of PHI and f/tPSA were 0.803 vs 0.644 (P<0.001).

Conclusion

PHI has a obvious advantage over the f/tPSA for prostate cancer detection in patients with PSA levels of "gray area" .

Key words: Prostate health index, PSA, Prostate cancer, Meta-analysis

Wei Jia, Bo Wu, Qian Chen, Xuhui Zhang, Dongwen Wang. Prostate health index versus free/total PSA for prostate cancer detection in patients with PSA levels in "gray area" : a systematic analysis[J]. Chinese Journal of Endourology(Electronic Edition), 2021, 15(06): 478-483.

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References 22

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文献	研究国家	研究类型	入组标准			人群年龄(岁)	样本数量(例)	前列腺癌患者数量(例)	PHI		f/tPSA		QUADAS得分
文献	研究国家	研究类型	PSA(ng/ml)	直肠指诊	年龄(岁)	人群年龄(岁)	样本数量(例)	前列腺癌患者数量(例)	临界值	AUC	临界值	AUC	QUADAS得分
Le等^[7]	美国	前瞻性	2.5~10	无	-	63	063	26	-	0.77	-	0.68	21
Jasen①等^[8]	荷兰	回顾性	2.5~10	有	-	66(55~75)	405	226	-	0.710	-	0.68	23
Jasen②等^[8]	奥地利	回顾性	2~10	-	≥50	60(50~77)	351	174	-	0.71	-	0.58	23
Catolona等^[9]	美国	前瞻性	2~10	无	≥50	62.8±7.0	892	430	21.30	0.71	-	0.65	27
Guazzoni等^[10]	意大利	前瞻性	2~10	无	-	63.3±8.2	268	107	48.5	0.76	0.29	0.58	27
Ito等^[11]	日本	回顾性	2~10	无	-	66(37~82)	239	53	24.9	-	0.23	-	23
Ferro等^[12]	意大利	前瞻性	2~10	-	≥50	60(50~73)	300	108	31.6	0.77	0.10	0.62	27
Lazzeri等^[13]	意大利/德国/法国/西班牙/英国	前瞻性	2~10	-	>40	64.2±7.5	646	264	27.6	0.67	0.22	0.64	26
Ng等^[14]	中国	回顾性	4~10	无	>45	65.9(50~79)0	230	21	26.54	0.78	0.28	0.57	23
Tan等^[15]	新加坡	前瞻性	4~10	无	50~75	065.4±6.46	157	30	26.75	0.79	0.10	0.42	27
Na等^[16]	中国	前瞻性	2~10	-	-	66.95±8.89	660	136	31.0	0.87	0.22	0.68	27
Cheng等^[17]	中国	前瞻性	4~10	-	-	66(61~72)	121	33	21.62	0.77	0.25	0.59	25
Fan等^[18]	中国	前瞻性	4~10或<4 DRE（+）	-	-	66(57.7~74.3)	307	95	35.15	0.78	0.27	0.63	27

文献	研究国家	研究类型	入组标准			人群年龄(岁)	样本数量(例)	前列腺癌患者数量(例)	PHI		f/tPSA		QUADAS得分
文献	研究国家	研究类型	PSA(ng/ml)	直肠指诊	年龄(岁)	人群年龄(岁)	样本数量(例)	前列腺癌患者数量(例)	临界值	AUC	临界值	AUC	QUADAS得分
Le等^[7]	美国	前瞻性	2.5~10	无	-	63	063	26	-	0.77	-	0.68	21
Jasen①等^[8]	荷兰	回顾性	2.5~10	有	-	66(55~75)	405	226	-	0.710	-	0.68	23
Jasen②等^[8]	奥地利	回顾性	2~10	-	≥50	60(50~77)	351	174	-	0.71	-	0.58	23
Catolona等^[9]	美国	前瞻性	2~10	无	≥50	62.8±7.0	892	430	21.30	0.71	-	0.65	27
Guazzoni等^[10]	意大利	前瞻性	2~10	无	-	63.3±8.2	268	107	48.5	0.76	0.29	0.58	27
Ito等^[11]	日本	回顾性	2~10	无	-	66(37~82)	239	53	24.9	-	0.23	-	23
Ferro等^[12]	意大利	前瞻性	2~10	-	≥50	60(50~73)	300	108	31.6	0.77	0.10	0.62	27
Lazzeri等^[13]	意大利/德国/法国/西班牙/英国	前瞻性	2~10	-	>40	64.2±7.5	646	264	27.6	0.67	0.22	0.64	26
Ng等^[14]	中国	回顾性	4~10	无	>45	65.9(50~79)0	230	21	26.54	0.78	0.28	0.57	23
Tan等^[15]	新加坡	前瞻性	4~10	无	50~75	065.4±6.46	157	30	26.75	0.79	0.10	0.42	27
Na等^[16]	中国	前瞻性	2~10	-	-	66.95±8.89	660	136	31.0	0.87	0.22	0.68	27
Cheng等^[17]	中国	前瞻性	4~10	-	-	66(61~72)	121	33	21.62	0.77	0.25	0.59	25
Fan等^[18]	中国	前瞻性	4~10或<4 DRE（+）	-	-	66(57.7~74.3)	307	95	35.15	0.78	0.27	0.63	27

文献	真阳性例数	假阳性例数	假阴性例数	真阴性例数	敏感性	特异性
Le等^[7]	23	13	3	24	0.885	0.649
Jasen①等^[8]	203	117	23	62	0.900	0.347
Jasen②等^[8]	157	122	17	55	0.900	0.311
Catolona等^[9]	387	342	43	120	0.900	0.260
Guazzoni等^[10]	46	16	61	145	0.429	0.900
Ito等^[11]	48	124	5	62	0.900	0.333
Ferro等^[12]	97	115	11	77	0.900	0.400
Lazzeri等^[13]	238	308	26	74	0.902	0.194
Ng等^[14]	19	105	2	104	0.900	0.498
Tan等^[15]	27	53	3	74	0.900	0.583
Na等^[16]	122	210	14	314	0.900	0.599
Cheng等^[17]	30	64	3	24	0.900	0.273
Fan等^[18]	86	113	9	99	0.900	0.467

文献	真阳性例数	假阳性例数	假阴性例数	真阴性例数	敏感性	特异性
Le等^[7]	23	13	3	24	0.885	0.649
Jasen①等^[8]	203	117	23	62	0.900	0.347
Jasen②等^[8]	157	122	17	55	0.900	0.311
Catolona等^[9]	387	342	43	120	0.900	0.260
Guazzoni等^[10]	46	16	61	145	0.429	0.900
Ito等^[11]	48	124	5	62	0.900	0.333
Ferro等^[12]	97	115	11	77	0.900	0.400
Lazzeri等^[13]	238	308	26	74	0.902	0.194
Ng等^[14]	19	105	2	104	0.900	0.498
Tan等^[15]	27	53	3	74	0.900	0.583
Na等^[16]	122	210	14	314	0.900	0.599
Cheng等^[17]	30	64	3	24	0.900	0.273
Fan等^[18]	86	113	9	99	0.900	0.467

文献	真阳性例数	假阳性例数	假阴性例数	真阴性例数	敏感性	特异性
Le等^[7]	023	022	03	15	0.885	0.405
Jasen①等^[8]	203	139	23	40	0.900	0.222
Jasen②等^[8]	157	156	17	21	0.900	0.119
Catolona等^[9]	387	379	43	83	0.900	0.180
Guazzoni等^[10]	021	016	86	1450	0.200	0.900
Ito等^[11]	048	145	05	41	0.900	0.220
Ferro等^[12]	097	154	11	38	0.900	0.200
Lazzeri等^[13]	239	300	25	82	0.905	0.215
Ng等^[14]	019	186	02	23	0.900	0.110
Tan等^[15]	027	118	03	09	0.900	0.071
Na等^[16]	122	380	14	1440	0.900	0.275
Cheng等^[17]	030	071	03	17	0.900	0.193
Fan等^[18]	086	177	09	35	0.900	0.167

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