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The clinical utility of measuring free‐to‐total prostate‐specific antigen (PSA) ratio and PSA density in differentiating between benign prostatic hyperplasia and prostate cancer
Author(s) -
KochaÑska-Dziurowicz,
Mielniczuk,
Stojko,
Kaletka
Publication year - 1998
Publication title -
british journal of urology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.773
H-Index - 148
eISSN - 1464-410X
pISSN - 0007-1331
DOI - 10.1046/j.1464-410x.1998.00643.x
Subject(s) - urology , prostate cancer , medicine , immunoradiometric assay , prostate , prostate specific antigen , transrectal ultrasonography , hyperplasia , receiver operating characteristic , cancer , gynecology , radioimmunoassay
Objective To evaluate the role of free‐to‐total prostate‐specific antigen ratio (f/tPSA), prostate volume and PSA density in differentiating between men with prostate cancer and benign prostatic hyperplasia (BPH). Patients and methods The study comprised 51 patients who were assessed after transurethral electroresection of the prostate (16 with prostate cancer and 35 with BPH). Patients with a tPSA of ≤4.0 ng/mL and ≥30.0 ng/mL were excluded from the analysis. Total and fPSA were measured using an immunoradiometric assay and prostate volume was determined by transrectal ultrasonography. The incidence of prostate cancer and BPH was then compared with the PSA variables to determine specificity and predictive value. Results Most patients with BPH had a tPSA of 4.0–6.0 ng/mL; no patients with BPH had a tPSA of >20.0 ng/mL. Most patients with prostate cancer had a f/tPSA of 6–10%. The area under the receiver operating characteristic curve for f/tPSA was significantly greater than that for tPSA ( P <0.003). Conclusions The measurement of f/tPSA and PSA density increase the specificity of the differential diagnosis between BPH and prostate cancer.