前列腺健康指数和前列腺健康指数密度在中高危前列腺癌诊断中的应用

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Application of prostate health index and prostate health index density in th detection of intermediate- to high-risk prostate cancer

CHEN Chenchen，ZHOU Yinghao，XU Yaozong，MENG Yibo，SHI Guowei，ZHANG Jun，YU Wandong （Department of Urology，The 5th People's Hospital of Shanghai，Fudan University，Shanghai 2Oo240，China）

ABSTRACT：ObjectiveTo evaluate the diagnostic value of prostate health index（PHI）and prostate health index density （PHID）in identifying intermediate-to high-risk prostate cancer（PCa）.MethodsClinicaldataof l6O treatment-naive patients with highlysuspected PCa，who underwent initial prostate biopsy inour hospital duringJul.2O2 andFeb.2024，were retrospectivelyanalyzed.Data includedage，body mass index（BMI），prostatevolume（PV），total prostate-specificantigen （tPSA），free PSA（fPSA），[-2]proPSA （p2PSA），PHI and PHID.Biopsy-positive results were stratified according to the EAU D'Amico risk criteria.Receiveroperating characteristic（ROC）curve and multivariate logisticregresionanalysis were employedto assssthe diagnostic performance of PHIand PHID in predictingPCaand identifying intermediate-to high-risk PCa.ResultsThere were statisticallsignificant diferences intPSA，p2PSA，PHIand PHID betweenthe negative andpositive groups，as well as among the low-，medium- and high-risk groups （ P<0.01 . Both PHI and PHID demonstrated good diagnostic performance in predicting PCa （ AUC=0.820 8 and O.875 7，respectively； all P<0.001 ），and in identifying intermediate- to high-risk PCa（AUC ：=0.8380 and O.878 3，respectively；all P<0.001 ） .Compared to the baseline model，the incorporation of PHIand PHID individually into the multivariate model significantly improved the screening performance for PCa （ AUC= 0. 910 and O.898，respectively；all P<0.001 ）.ConclusionPHI and PHID exhibit high diagnostic efficacy in screening PCa， particularly in identifying intermediate- to high-risk disease.

KEY WORDS：prostate cancer;intermediate-to high-risk prostatecancer;prostate health index;prostatehealth index density

中图分类号：R737.25 文献标志码：A DOI：10.3969/j.issn.1009-8291.2025.08.002

前列腺癌（prostatecancer，PCa）是常见的男性泌尿生殖系统恶性肿瘤，近年来的发病率和死亡率均显著上升[1-2]。（剩余11064字）