The current study supported the diagnostic accuracy of PHI in patients with high (>10 ng/ml) tPSA levels.
The inclusion of PHI in the biopsy decision path of these patients would decrease the number of unnecessary biopsies by an extent of 50.0%, while missing only few cases with clinically significant PCa.
As this marker is also associated with cancer aggressiveness, high percentage of PHI levels should guide the subsequent diagnostic and therapeutic approaches.