The clinical importance of percentage free prostate-specific antigen (PSA) in the PSA level of 4-20 ng/ml

Abstract

Objective: The current study aimed to evaluate the diagnostic efficacy of percentage free/total prostate-specific antigen ratio (%fPSA = free/total PSA*100) for prostate cancer diagnosis in different PSA levels (4.1 - 10 ng/ml and 10.01 - 20 ng/ml). Design: Retrospective study Setting: Department of Urology, Çorum Training and Resarch Hospital, Hitit University Subjects: Patients who underwent prostate biopsy with a PSA level of 4.1 - 20 ng/ml Intervention: Prostate biopsy was performed for patients who had PSA level > 4 ng/ml. Main outcome measures: The patients who underwent transrectal ultrasound guided prostate biopsy between January 2010 and January 2015 were evaluated retrospectively. The patients were divided into two groups according to the PSA levels. The PSA levels of patients in Group 1 was 4.1 - 10 ng/ml and 10.01 - 20 ng/ml in Group 2. The receiver operating characterictic (ROC) curves were analyzed for the diagnostic efficacy of %fPSA in different PSA levels. Results: There were 1213 patients in the present study. Of these patients, 876 and 337 patients were in groups 1 and 2, respectively. The mean age and PSA level of the patients was 66.21 ± 7.45 years, 6.48 ± 1.58 ng/ml and 69.36 ± 8.56 years, 13.63 ± 270 ng/ml in groups 1 and 2, respectively. The ROC curve analyzes demonstrated the diagnostic efficacy of percentage fPSA and there was a significant difference between percentage fPSA and PSA in two groups. Conclusion: The %fPSA is effective for the diagnosis of prostate cancer in Turkish patients having both PSA level of 4.1 - 10 and 10.01 - 20 ng/ml. Clinicans should consider that %fPSA can predict biopsy outcomes. © 2018, Kuwait Medical Association. All rights reserved.