On the Clinical Usefulness of the Free-to-Total Prostate-Specific Antigen Ratio

2006 ◽  
Vol 21 (1) ◽  
pp. 1-5 ◽  
Author(s):  
S. Ciatto ◽  
T. Rubeca ◽  
R. Franceschini ◽  
C. Trevisiol ◽  
M. Confortini ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Prostate Specific Antigen ◽  
Specific Antigen ◽  
Clinical Usefulness ◽  
Clinical Use ◽  
Prostate Biopsies ◽  
Total Prostate Specific Antigen ◽  
Total Psa

The free-to-total prostate-specific antigen ratio (F/T PSA) is associated with the presence of prostate cancer and is thus used as an indicator for suspicion of prostate cancer and as a determinant for biopsy. We reviewed a recent retrospective series of 966 consecutive prostate biopsies where F/T PSA was blindly determined and did not influence biopsy indication. We simulated the association of F/T PSA with biopsy outcome and its impact as a biopsy determinant. When adopting an F/T PSA cutoff of 10%, 13%, 16% or 20% among random sextant biopsies in the 4–10 ng/mL total PSA range, the sensitivity was 15%, 37%, 55% and 72% and the specificity 89%, 80%, 64% and 44%, respectively. Using F/T PSA as a biopsy determinant, from 1.7 to 2.6 cancer biopsies would have been delayed to avoid 10 benign biopsies. As this balance is not acceptable, F/T PSA has no role as a biopsy indicator and its clinical use is questionable.

Preliminary Results of Clinical Evaluation of the Free/Total Prostate-Specific Antigen Ratio in a Multicentric Study

1996 ◽  
Vol 82 (6) ◽  
pp. 543-549 ◽  
Author(s):  
Riccardo Mione ◽  
Giuseppe Aimo ◽  
Emilio Bombardieri ◽  
Alberto Cianetti ◽  
Mario Correale ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Prostate Specific Antigen ◽  
Dose Range ◽  
Specific Antigen ◽  
Diagnostic Efficiency ◽  
Clinical Value ◽  
Multicentric Study ◽  
Free Psa ◽  
Prostate Biopsies ◽  
Total Psa

Aims and Background The free/total (F/T) prostate-specific antigen (PSA) ratio is probably the most promising tool proposed to increase the specificity of PSA in the diagnosis of prostate cancer. The aim of the present study was to evaluate the clinical value of the F/T ratio in 138 patients with benign hyperplasia, 101 with untreated prostate cancer, and 176 apparently healthy men. Methods We used a new immunometric assay of free PSA (FPSA-RIACT, CIS Diagnostici, Italy) which has shown good analytical performance; sample handling and storage under routine conditions did not affect the antigen stability. Results The diagnostic efficiency of the F/T ratio was significantly better than that of total PSA. In patients with total PSA ranging from 4 to 10 ng/ml, at a specificity level of 95% total PSA showed a sensitivity of 7%, whereas the sensitivity of F/T increased to 70%. Using the F/T ratio as a decision tool in association with total PSA and considering all cases candidate to biopsy (total PSA greater than 3.79 ng/ml corresponding to the 95% level), we demonstrated a 35% reduction of total biopsies that would have been required on the basis of total PSA alone. Conclusions The determination of the percentage of F/T serum PSA significantly improves the specificity of the marker, particularly in the 4-10 ng/ml dose range where unnecessary prostate biopsies can be reduced.

scholarly journals CAN PROSTATE-SPECIFIC ANTIGEN DENSITY AND FREE / TOTAL PROSTATE-SPECIFIC ANTIGEN RATIO PREDICT CLINICALLY SIGNIFICANT PROSTATE CANCER (GLEASON ≥ 7) IN PATİENTS DIAGNOSED PROSTATE CANCER ON BIOPSY WITH A PROSTATE-SPECIFIC ANTIGEN LEVEL OF 2.5 -10 NG/ML?

2021 ◽  
Author(s):  
Fatih Bicaklioglu ◽  
Hasan Aydin ◽  
Ahmet Özgür Güçtaş ◽  
Hamit Zafer Aksoy
Keyword(s):  
Prostate Cancer ◽  
Prostate Specific Antigen ◽  
Sensitivity And Specificity ◽  
Prostate Biopsy ◽  
Specific Antigen ◽  
Free Psa ◽  
Total Prostate Specific Antigen ◽  
Prostate Specific Antigen Density ◽  
Clinically Significant ◽  
Total Psa

Introduction Many men with non-clinically significant PCa (N-CSPCa) will not progress to become symptomatic within their lifetime. If we can predict clinically significant PCa (CSPCa), we can prevent patients from unnecessary biopsies, overdiagnoses, and overtreatment. The purpose of this study was to determine whether PSAD and f/t PSA can predict CSPCa (Gleason ≥ 7) in patients diagnosed with prostate cancer on biopsy with a PSA level of 2.5-10 ng/ml or not. Materials and Methods 78 patients who underwent TRUSG-guided prostate biopsy with PSA 2.5-10.0 in our clinic between March 2017 - August 2020 and whose pathology result was reported as prostate adenocarcinoma, were retrospectively evaluated. In addition to the demographic content of the patients, PSA, free PSA, prostate size (with TRUSG), rectal examination findings and prostate biopsy pathology results were recorded. Clinically significant prostate cancer was defined as a Gleason score 7. Results The mean age of the patients was 66.9 ± 8.4, PSA value was 6.9 ± 1.8, free / total PSA ratio was 18 ± 8.1%, and PSA density was 0.150 ± 0.078. The P values of PSA, free PSA, PSAD, f/t PSA, and prostate volume between CSPCa and N- CSPCa groups were 0.010, 0.780, 0.001, 0.084, and 0.030, respectively. The area under the ROC curve (AUC) of the PSAD for predicting CSPCa was 0.719 with a 95% Cl (0.604–0.835), and the standard errors were 0.062 and 0.059, respectively. When PSAD cutoff was 0.130 for predicting CSPCa, sensitivity and specificity were 75% and 63%, respectively. Conclusion PSAD can be used for predicting CSPCa, but f/t PSA can not. PSAD is not a strong stand-alone tool with its sensitivity and specificity, but we suggest that PSAD can be a part of future nomograms for predicting CSPCa and future protocols for active surveillance. Key words:prostate-specific antigen; clinically significant prostate cancer

scholarly journals Prostate-Specific Antigen: From Promising to Disappointment Tool for Diagnosis of Chronic Renal Failure in Predialysis Patients

2021 ◽  
Vol 07 (02) ◽  
pp. 082-084
Author(s):  
Ali Abdul Hussein S Al-Janabi
Keyword(s):  
Prostate Cancer ◽  
Renal Failure ◽  
Chronic Renal Failure ◽  
Prostate Specific Antigen ◽  
Specific Antigen ◽  
Enzyme Linked Immunosorbent Assay ◽  
Elderly Men ◽  
A Value ◽  
Total Psa ◽  
Moderate Elevation

Abstract Introduction Prostate-specific antigen (PSA) is a biomarker commonly used for detection of prostate cancer. Its viability as a marker for diagnosis of chronic renal failure (CRF) in predialysis patients was investigated. Methods Sera from 230 patients with CRF were analyzed by enzyme-linked immunosorbent assay (ELISA) for determining total PSA (tPSA) levels before hemodialysis. Results Of the patients investigated, 98.69% had a normal PSA level with a value less than 4 ng/mL. Three elderly men with both kidney failure showed a moderate elevation of PSA level. Conclusion PSA is considered a nonsignificant indicator for diagnosis of CRF.

Cumulative Prostate Cancer Risk Assessment with the Aid of the Free-to-Total Prostate Specific Antigen Ratio

2004 ◽  
Vol 45 (2) ◽  
pp. 160-165 ◽  
Author(s):  
Gunnar Aus ◽  
Charlotte Becker ◽  
Stefan Franzén ◽  
Hans Lilja ◽  
Pär Lodding ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Risk Assessment ◽  
Cancer Risk ◽  
Prostate Specific Antigen ◽  
Specific Antigen ◽  
Prostate Cancer Risk ◽  
Cancer Risk Assessment ◽  
Total Prostate Specific Antigen
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