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The influence of prostate volume on the ratio of free to total prostate specific antigen in serum of patients with prostate carcinoma and benign prostate hyperplasia
Author(s) -
Stephan Carsten,
Lein Michael,
Jung Klaus,
Schnorr Dietmar,
Loening Stefan A.
Publication year - 1997
Publication title -
cancer
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 3.052
H-Index - 304
eISSN - 1097-0142
pISSN - 0008-543X
DOI - 10.1002/(sici)1097-0142(19970101)79:1<104::aid-cncr15>3.0.co;2-8
Subject(s) - medicine , prostate , hyperplasia , prostate carcinoma , prostate specific antigen , urology , pca3 , oncology , cancer
Abstract BACKGROUND Determining the ratio of free to total prostate specific antigen (f‐PSA to t‐PSA, calculated as the percentage of f‐PSA [f‐PSA%]) in serum allows for a clearer distinction between patients with prostate carcinoma (PCa) and patients with benign prostate hyperplasia (BPH) than determining the level of t‐PSA alone. To find influencing factors on f‐PSA%, the authors investigated prostate volume, TNM classification, and tumor stage. METHODS The authors measured f‐PSA and t‐PSA in 36 men with untreated PCa (tumor classification: T1, 2, 3pN0, M0), 44 patients with BPH, and 54 healthy controls. Prostate volume was determined by transrectal ultrasound. RESULTS The median values of t‐PSA and f‐PSA% were 7.8 μg/L and 10.5% in PCa patients, 4.3 μg/L and 20.8% in patients with BPH, and 1.4 μg/L and 23.6% in the control group. Patients with PCa had a significantly lower proportion of f‐PSA than BPH patients and healthy men. There was no correlation of f‐PSA% to TNM stage or tumor grade. In PCa patients a significant positive correlation (correlation coefficient [r] = 0.51, P < 0.001) was found between f‐PSA% and prostate volume, whereas there was no significant correlation in BPH patients (r = ‐0.27, P > 0.05). There was a significant difference in f‐PSA% between PCa and BPH patients with prostate volumes smaller than 40 cm 3 (9.0% vs. 21.6%, P < 0.01) but not between patients in these 2 groups with prostate volumes exceeding 40 cm 3 (15.1% vs. 18.2%, P = 0.11). CONCLUSIONS Determining the ratio of f‐PSA to t‐PSA to discriminate between PCa and BPH patients yields significant results only in men with a prostate volume of less than 40 cm 3 . Cancer 1997; 79:104‐9. © 1997 American Cancer Society.