The Impact of Free/Total PSA Ratio on Prostate Cancer Diagnosis in Patients with PSA Level Between 2,5-10 mg/dl Undergoing Transrectal Prostate Biopsy

Aim:  In this study, we aimed to compare the outcomes of pathologic results of patients underwent transrectal prostate biopsy (TRIB) with free/total PSA ratio. Material and Method: Patients having a PSA level between 2.5-10 ng/ml and underwent TRIB were retrospectively analyzed. Patients were divided into two groups as having a free/total PSA ratio below and over 20%. The ratio below 20% was in Group 1 and over 20% were in Group 2. Results: There were 60 patients in Group 1 and 82 patients in Group 2. PSA levels were 7,45 ± 2,14 and 6,31 ± 1,89 for groups 1 and 2, respectively (p=0.067). Fourteen patients in Group 1 (23%) and 15 patients in Group 2 (18%) were diagnosed with prostate cancer. Sensitivity was 100% and specificity was 23% when PSA level was between 2.5 and 10. Discussion: Free/Total PSA ratio can be applied to PSA levels between 2.5 and 10. Even though it has a low specificity, with high sensitivity, it can be used in urologic practice