Open AccessPercentage of free prostate‐specific antigen (PSA) is a useful method in deciding to perform prostate biopsy with higher core numbers in patients with low PSA cut‐off values
Author(s) -
Yilmaz Hasan,
Ciftci Seyfettin,
Yavuz Ufuk,
Ustuner Murat,
Saribacak Ali,
Dillioglugil Ozdal
Publication year - 2015
Publication title -
the kaohsiung journal of medical sciences
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.439
H-Index - 36
eISSN - 2410-8650
pISSN - 1607-551X
DOI - 10.1016/j.kjms.2015.02.006
Subject(s) - medicine , rectal examination , prostate , urology , prostate cancer , prostate specific antigen , biopsy , receiver operating characteristic , malignancy , prostate biopsy , intraepithelial neoplasia , radiology , cancer , pathology
The aim of this study was to evaluate the predictive role of percentage of free prostate‐specific antigen (%fPSA) cut‐points in prostate cancer (PCa) detection in patients with total PSA (tPSA) levels between 2.5 ng/mL and 10.0 ng/mL. In total, 1321 consecutive initial transrectal ultrasound (TRUS)‐guided 12‐core biopsies performed between 2005 and 2011 were evaluated retrospectively. Benign pathologies, high‐grade prostatic intraepithelial neoplasia, and atypical small acinary proliferations were categorized as noncancerous (benign), and prostate adenocarcinomas were categorized as cancerous (malignant). The patients were categorized according to: Catalona's published %fPSA categories (<10%, 10–15%, 15–20%, 20–25%, or > 25%); digital rectal examination (DRE) results [benign (negative) or suspicious of malignancy (positive)]. There was a significant relationship between the %fPSA cut‐points and detection of PCa in DRE‐negative patients. The presence of a 10% cut‐point increased the probability of PCa threefold. The %fPSA was significantly more related to PCa than the tPSA value in receiver operating characteristic (ROC) curve analyses ( p = 0.001). Based on our findings, a lower %fPSA, especially <10%, is an important parameter when deciding whether to perform a biopsy on patients with a tPSA between 2.5 ng/mL and 10 ng/mL.