PMID- 10746371
OWN - NLM
STAT- MEDLINE
DCOM- 20000503
LR  - 20190915
IS  - 0210-4806 (Print)
IS  - 0210-4806 (Linking)
VI  - 24
IP  - 1
DP  - 2000 Jan
TI  - [Usefulness of free PSA/total PSA ratio in the diagnosis of prostatic cancer in 
      symptomatic patients with PSA levels ranging from 2.5 to 20 ng/ml].
PG  - 24-30
AB  - OBJECTIVE: To evaluate the value of free PSA/total PSA ratio (fPSA/tPSA) to boost 
      total PSA (tPSA) specificity in the diagnosis of prostate cancer in a series of 
      symptomatic patients. MATERIAL AND METHOD: Prospective study on 334 patients 
      presenting symptoms compatible with PBH and tPSA (ProStatus, Wallace Oy, Turku, 
      Finland) between 2.5 and 20 ng/ml, and mean age 67.2 +/- 7 (49-87). Patients were 
      divided into 3 groups: Group I (normal DRE and tPSA between 2.5 and 10 
      ng/ml)--189 patients. Group II (normal DRE and tPSA between 10 and 20 ng/ml)--78 
      patients. Group III (suspicion DRE and sPSA between 2.5 and 20 ng/ml)--67 
      patients. For each group, the sensitivity, specificity and ROC curves were 
      calculated for several cut-off values of the lPSA/tPSA ratio. RESULTS: Group 
      I--Prostate cancer was diagnosed in 11% (20/189) patients. Significant 
      differences were found only in the lPSA/tPSA ratio (p = 0.01). Using 27% as the 
      cut-off value, cancer would have been diagnosed in 95% (19 of 20) patients, 
      decreasing the total number of negative biopsies by 21% (39 of 189). Group 
      II--Prostate cancer was diagnosed in 19% (15/78) patients. The only significant 
      differences found were in prostate volume (p = 0.02). Using 30% as the cut-off 
      value, 93% (14 of 15) patients with cancer would have been diagnosed, decreasing 
      the total number of biopsies by 6.5% (5 of 78) and the number of negative 
      biopsies by 8% (5 of 63). Group III--Prostate cancer was detected in 72% (48/67) 
      patients. Significant differences were found in lPSA/tPSA ratio (p = 0.003), 
      prostate volume (p = 0.02) and presence of ultrasound nodes (p = 0.004). Using 
      25% as the cut-off value, 96% (46 of 48) of patients with cancer would have been 
      diagnosed, decreasing the total number of biopsies by 13% (9 of 67) and the 
      number of negative biopsies by 47% (9 of 19). CONCLUSIONS: We advise use of 
      lPSA/tPSA ratio only in patients with normal DRE and tPSA between 2.5 and 10 
      ng/ml. Biopsing patients with lPSA percent equal to or lower than 27% would have 
      prevented 23% of negative biopsies while still maintaining a diagnostic 
      sensitivity of 95%.
FAU - Herranz Amo, F
AU  - Herranz Amo F
AD  - Servicio de Urologia, H.G.U. Gregorio Maranon, Madrid.
FAU - Verdu Tartajo, F
AU  - Verdu Tartajo F
FAU - Diez Cordero, J M
AU  - Diez Cordero JM
FAU - Leal Hernandez, F
AU  - Leal Hernandez F
FAU - Bielsa Carrillo, A
AU  - Bielsa Carrillo A
FAU - Garcia Burgos, J
AU  - Garcia Burgos J
FAU - Subira Rios, D
AU  - Subira Rios D
LA  - spa
PT  - English Abstract
PT  - Journal Article
TT  - Utilidad del cociente PSA libre/PSA total en el diagnostico del cancer de 
      prostata en pacientes sintomaticos con niveles de PSA entre 2,5 y 20 ng/ml.
PL  - Spain
TA  - Actas Urol Esp
JT  - Actas urologicas espanolas
JID - 7704993
RN  - EC 3.4.21.77 (Prostate-Specific Antigen)
SB  - IM
MH  - Aged
MH  - Aged, 80 and over
MH  - False Negative Reactions
MH  - False Positive Reactions
MH  - Humans
MH  - Male
MH  - Middle Aged
MH  - Prospective Studies
MH  - Prostate-Specific Antigen/*blood
MH  - Prostatic Neoplasms/*blood/complications/*diagnosis
MH  - Sensitivity and Specificity
EDAT- 2000/04/04 09:00
MHDA- 2000/05/08 09:00
CRDT- 2000/04/04 09:00
PHST- 2000/04/04 09:00 [pubmed]
PHST- 2000/05/08 09:00 [medline]
PHST- 2000/04/04 09:00 [entrez]
AID - S0210-4806(00)72400-4 [pii]
AID - 10.1016/s0210-4806(00)72400-4 [doi]
PST - ppublish
SO  - Actas Urol Esp. 2000 Jan;24(1):24-30. doi: 10.1016/s0210-4806(00)72400-4.