Diagnostic value of [-2]proPSA and PHI index (review of literature)

Measurement of blood prostate-specific antigen (PSA) levels resulted in an increasing number of performed prostate biopsies and the lower age-adjusted PSA threshold led to a larger number of unnecessary prostate biopsies. Today prostate cancer (PC) is identified in only 35% of the patients with a total PSA level of 4–10 ng/ml and PSA-negative PC occurs in 20–25%. Obviously, PSA as an independent marker has exhausted its diagnostic potentialities. The new PC markers presented in the literature indubitably deserve close attention and further investigation. The most promising markers also include [-2]proPSA and PHI index. According to the latest evidence available in the literature now, [-2]proPSA and PHI index are the best predictors of PC during both primary and secondary prostate biopsy. Some publications show it possible to use the PHI index in planning both primary and secondary prostate biopsies, by constructing risk normograms, in combination with other individual patient examination parameters, including those with the other latest biomarkers of PC. The use of [-2]proPSA and PHI index in everyday practice can assist in increasing the specificity of PC diagnosis and reducing the number of unnecessary prostate biopsies. The apparent importance of the diagnosis of PC at its early stages (including that using the PHI index) made us investigate this topic. Despite a great number of printed papers dealing with this problem, their number continues to increase, but clear guides to make actions in this field are yet to be elaborated and a decision on each specific case is made individually.