Proper Cut-off Value of Free to Total PSA Ratio for Detection of Prostate Cancer in Korean Men.
10.3349/ymj.2004.45.5.873
- Author:
Young Jae IM
1
;
Jae Wook KIM
;
Sung Joon HONG
;
Byung Ha CHUNG
Author Information
1. Department of Urology, Urological Science Institute, Yonsei University College of Medicine, Seoul, Korea. chung 646@yumc.yonsei.ac.kr
- Publication Type:Original Article
- Keywords:
Prostate cancer;
biopsy;
free PSA;
Korea
- MeSH:
Biopsy;
Humans;
Male;
Middle Aged;
Prostate/pathology;
Prostate-Specific Antigen/*blood;
Prostatic Neoplasms/*diagnosis;
ROC Curve
- From:Yonsei Medical Journal
2004;45(5):873-878
- CountryRepublic of Korea
- Language:English
-
Abstract:
To assess whether the free-to-total prostate specific antigen (PSA) ratio (F/T PSA ratio) would enhance prostate cancer detection in Korean men with serum total PSA levels between 4 and 20 ng/ml. Methods: A total of 240 consecutive patients whose serum PSA levels were between 4 and 20 ng/ml were enrolled in this two-year study. All patients underwent ultrasound-guided transrectal biopsies of the prostate gland. The F/T PSA ratio was measured using the Roche immunoassay. Results: Of the 240 patients, 202 (84%) had benign histologies, while 38 (16%) had prostate cancer. The two patient groups were well matched for age. The mean F/T PSA ratio showed a statistically significant difference between the two groups: in the benign histology group it was 0.14 (0.04 - 0.37), and 0.10 (0.08 - 0.20) in the prostate cancer group (p< 0.05). Out of the 183 patients with a PSA level between 4-10ng/ml, the mean F/T PSA ratios were 0.14 and 0.11 in the benign histology (n=158) and prostate cancer groups (n=25), respectively (p< 0.05). From the 57 patients with a PSA level between 10 - 20 ng/ml, the mean F/T PSA ratios were 0.14 and 0.10 in the benign histology (n=44) and prostate cancer groups (n=13), respectively (p< 0.05). Overall, when the cut-off value of the F/T PSA ratio was 0.10, the sensitivity and specificity were 75.0% and 76.5%, while for the cut-off value of 0.15 they were 83.3% and 39.7% respectively. Conclusion: Our data demonstrated the usefulness of the free to total PSA ratio in distinguishing benign prostate disease and cancer disease, hence eliminating unnecessary biopsies. It is recommended that a cut-off value for the F/T PSA ratio of 0.10 be applied to Korean men which this is lower than the value used in Western countries.
