The Value And Interference Factors Of Prostate Health Index In The Diagnosis Of Prostate Cancer

Objective:To investigate the influence of multiple factors on PSA and PHI and the influence of various factors on the diagnosis of prostate cancer by collecting prostate MRI,prostate health index PHI,urine analysis,urography,etc.provide more effective reference for diagnosis and differential diagnosis of prostate cancer.Method:Clinical data of 82 patients with abnormal screening PSA in our hospital from March 2019 to December 2019 and pathological results obtained by puncture or prostate resection were retrospectively analyzed.The pathological results were divided into benign group and malignant group Single factor and multi-factor analysis were performed to compare age,prostate volume size,urinary tract infection,whether there was a indwelling catheter,whether there were bladder stones,PI-RADS score(2nd edition),Gleason pathological score,etc.Results:1.benign and malignant groups TPSA,prostate health index PHI,prostate volume,catheter,inflammation,bladder stones,PI-RADS scores were compared.the difference between the health index and prostate volume and PI-RADS score was statistically significant(P<0.05).difference in catheter,inflammation,and bladder stones was not statistically significant(P>0.05).2.the statistically significant indicators of difference in univariate analysis TPSA、health index PHI、prostate volume,PI-RADS score were included in multivariate regression analysis.There was collinearity between TPSA and health index PHI,and the health index was selected to be included in multivariate regression analysis.The results showed that the health index PHI、prostate volume,PI-RADS score,multiple factors logistics regression were statistically significant(P<0.05)Diagnosis independent risk factors for prostate cancer,risk OR=1.021,2.487,1.044.3.The Spearman correlation between catheter and TPSA was positive(P<0.05),which was higher than that with catheter,but not with PHI(P>0.05).There was no significant correlation between inflammation,bladder stone and Spearman of TPSA and PHI(P>0.05).The correlation among prostate volume,pi-rads score,pathological score,TPSA and PHI was positive(P<0.05).R=0.427 for prostate volume and health index PHI,r=0.298 for TPSA,r=0.666 for pi-rads and health index PHI,r=0.597 for TPSA,r=0.572 for pathology score and health index PHI,r=0.565 for TPSA,and no difference in correlation between pathology score and health index PHI and TPSA Big.The correlation between pi-rads score,pathological score and Spearman of TPSA and PHI was positive(P<0.05).4.The predictive ability of TPSA,health index PHI for benign and malignant was 0.797 and 0.942 respectively,which was statistically significant(P<0.05).TPSA boundary value was 27.875,sensitivity was 68.6%,specificity was 97.9%,and jorden index was 0.665.Health index PHI boundary value of 65.34,sensitivity 85.7%,specificity 93.6%,Jorden index 0.773.The health index PHI AUC value,Jordan index,sensitivity were higher than TPSA.5.When the PHI value is greater than 50,the probability of prostate cancer reaches 77.5%,and when the PHI value is greater than 60,the probability of prostate cancer reaches 88.2%.Conclusion:1.The presence or absence of a catheter and the size of the prostate affect the serum PSA and PHI levels.The prostate volume is an independent factor affecting the two.The PHI is less interfered by the catheter than PSA.2.When the PSA is slightly elevated and there is no clear pathological result,the PHI can predict prostate cancer more sensitively than TPSA,which can be used to choose whether to perform needle biopsy.