Korean J Urol.  2001 Aug;42(8):815-820.

The Effectiveness of Free/Total Prostate Specific Antigen (PSA) Ratio for Increasing the Detection Rate of Prostate Cancer in Patients with Serum PSA Level 4-10ng/ml

• Lee SJ
• Seo IY
• Kim JS
• Rim JS

Abstract

PURPOSE: We studied how to increase the detection rate of prostatic cancer in men with normal DRE and the diagnostic gray zone of PSA in whom transrectal prostate biopsies were done.
MATERIALS AND METHODS
We analyzed 132 patients with normal DRE and serum PSA greater than 4ng/ml, in whom transrectal prostate biopsies were done between January 1, 1996 and July 31, 2000. These patients were divided into two groups, one group having normal DRE and serum PSA level between 4 and 10ng/ml, in whom transrectal prostate biopsies was done and another group having normal DRE and serum PSA level between upper limit of age-specific PSA reference ranges (APSA-R) and 10ng/ml, in whom transrectal prostate biopsies was done. We applied PSAD and F/T PSA ratio to each group.
RESULTS
Eighty-one patients with serum PSA level between 4 and 10ng/ml and 67 patients with serum PSA level between upper limit of APSA-R and 10ng/ml, underwent prostate sextant biopsies. In each group, prostate cancer detection rates were 7.4% and 7.5%. When we applied F/T PSA ratio cut off of 0.15 in each group, prostate cancer detection rates were 19.4% and 22.7%, individually (p<0.05).
CONCLUSIONS
Application of F/T PSA ratio can be used significantly to elevate the detection rate of prostate cancer and reduce safely the number of biopsies performed in patients with gray zone of serum PSA levels.

Keyword

PSA; Prostate cancer; PSA ratio; Tumor marker

MeSH Terms

Biopsy
Humans
Male
Prostate*
Prostate-Specific Antigen*
Prostatic Neoplasms*
Reference Values
Prostate-Specific Antigen