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Meta-Analysis
. 2022 May 16;60(8):1261-1277.
doi: 10.1515/cclm-2022-0354. Print 2022 Jul 26.

Prostate health index (PHI) as a reliable biomarker for prostate cancer: a systematic review and meta-analysis

Luisa Agnello  1 , Matteo Vidali  2 , Rosaria Vincenza Giglio  1   3 , Caterina Maria Gambino  1   3 , Anna Maria Ciaccio  4 , Bruna Lo Sasso  1   3 , Marcello Ciaccio  1   3
Affiliations
Free article
Meta-Analysis

Prostate health index (PHI) as a reliable biomarker for prostate cancer: a systematic review and meta-analysis

Luisa Agnello et al. Clin Chem Lab Med. .
Free article

Abstract

Objectives: Prostate cancer (PCa) represents the second most common solid cancer in men worldwide. In the last decades, the prostate health index (PHI) emerged as a reliable biomarker for detecting PCa and differentiating between non-aggressive and aggressive forms. However, before introducing it in clinical practice, more evidence is required. Thus, we performed a systematic review and meta-analysis for assessing the diagnostic performance of PHI for PCa and for detecting clinically significant PCa (csPCa).

Methods: Relevant publications were identified by a systematic literature search on PubMed and Web of Science from inception to January 11, 2022.

Results: Sixty studies, including 14,255 individuals, met the inclusion criteria for our meta-analysis. The pooled sensitivity and specificity of PHI for PCa detection was 0.791 (95%CI 0.739-0.834) and 0.625 (95%CI 0.560-0.686), respectively. The pooled sensitivity and specificity of PHI for csPCa detection was 0.874 (95%CI 0.803-0.923) and 0.569 (95%CI 0.458-0.674), respectively. Additionally, the diagnostic odds ratio was 6.302 and 9.206, respectively, for PCa and csPCa detection, suggesting moderate to good effectiveness of PHI as a diagnostic test.

Conclusions: PHI has a high accuracy for detecting PCa and discriminating between aggressive and non-aggressive PCa. Thus, it could be useful as a biomarker in predicting patients harbouring more aggressive cancer and guiding biopsy decisions.

Keywords: PCa; biomarker; clinically significant prostate cancer (csPCa); diagnosis; prostate health index (PHI); prostate tumor; screening.

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