The Value of Free/Total Prostate Specific Antigen Ratio in the Diagnosis of Prostate Cancer.
- Author:
Moon Kab SON
1
;
Hyun Soo KIM
;
Tae Hee OH
Author Information
1. Department of Urology, College of Medicine, Sungkyunkwan University, Seoul, Korea.
- Publication Type:Original Article
- Keywords:
Prostate cancer;
Diagnosis;
Free to total PSA ratio
- MeSH:
Biopsy;
Diagnosis*;
Humans;
Male;
Prostate*;
Prostate-Specific Antigen*;
Prostatic Neoplasms*;
ROC Curve;
Ultrasonography
- From:Korean Journal of Urology
1998;39(5):459-463
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
PURPOSE: We investigated the value of the free to total PSA ratio of intermediate serum PSA levels(4-20ng/m1) in the detection of prostate cancer. MATERIALS AND METHODS: Free PSA, total PSA levels and free to total PSA ratio(F/T ratio) were measured on sera samples of 103 men with symptomatic BPH and 20 men with prostate cancer, who were proved by biopsy, by using ELSA-PSA2 and FPSA-RIACT. And we used transrectal ultrasound determined prostate volume to calculated PSA density(PSAD). RESULTS: In all patients, mean PSAD was significantly greater for patients with cancer(2.07+/- 1.65) versus BPH(0.120.12). The F/T ratio was significantly lower for cancer(0.12+/-0.04) compared with BPH(0.32+/-0.20). At a time, when serum PSA between 4 and 20ng/m1 was considered in 8 patients with cancer and 38 patients with BPH, mean total serum PSA was significantly greater for patients with cancer(12.02+/- 3.54ng/m1) versus BPH(7.21 +/-3.68ng/m1). Mean PSAD was significantly greater for patients with cancer(0.36+/- 0.12) versus BPH(0.20+/-0.12) and the F/T ratio was significantly lower for cancer(0.14+/-0.03) compared with BPH(0.25+/-0.12). Use of the Ff ratio of 0.15 resulted in the highest sensitivity(75%) and specificity(89.5%) and the F/T ratio was superior to total PSA when compared with receiver operating characteristic curve . CONCLUSIONS: The F/T ratio give a significant improvement over total PSA value in the diagnosis of prostate cancer in patients with intermediate PSA levels. But, to assess accurately usefullness of F/T ratio in early prostate cancer detection, further studies are needed and consensual threshold value is necessary.
