title: [Diagnostic efficacy of free SPA/total PSA ratio in the diagnosis of prostatic carcinoma].
abstract: Prostate specific antigen, specific organ and tissue marker, is a glycoprotein present in serum in different molecular forms, i.e. not protein bound and bound to proteins (PSA-ACT and PSA-AMG). The total PSA is expressed by the sum of the non protein bound value (free-PSA) and PSA-ACT. The aim of our study was to evaluate the hypothesis that measurement of free/total PSA ratio may be helpful in the differential diagnosis of prostatic pathology. Our study was conducted on 350 patients, to whom the total-PSA, free-PSA and f/t PSA had been performed; 250 patients showed a total PSA between 2.5 and 10 ng/ml and 185 of them had symptoms of bladder out-flow obstruction. In all of the 250 patients digital rectal examination, transrectal ultrasound and prostatic biopsy were performed. 100 patients were controls. The cut-off to differentiate between benign and malignant prostatic disease was 16%. The pathologic diagnosis was related to the f/t PSA ratio, and in particular those patients with a f/t PSA lower than 16% were expected to be prostatic carcinoma, while those with a f/t PSA higher than 16% were expected to be benign prostatic hypertrophy. The diagnostic accuracy of the ratio was calculated, and it was observed that it was 88.65% in the diagnosis of benign prostatic hypertrophy, while in the diagnosis of prostatic carcinoma it was 84.5%. We can therefore assume that f/t PSA can add useful information on prostatic pathology, eventually sparing unnecessary prostatic biopsies.
authors.affiliation: Clinica Urologica, Università degli Studi, Ancona.
authors.forename: D
authors.initials: D
authors.lastname: Minardi
authors.forename: A
authors.initials: A
authors.lastname: Recchioni
authors.forename: M
authors.initials: M
authors.lastname: Baldassari
authors.forename: D
authors.initials: D
authors.lastname: Governatori
authors.forename: L
authors.initials: L
authors.lastname: Giammarco
authors.forename: G
authors.initials: G
authors.lastname: De Sio
authors.forename: G
authors.initials: G
authors.lastname: Muzzonigro
authors.forename: M
authors.initials: M
authors.lastname: Polito
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D006801:Humans; D008297:Male; D008875:Middle Aged; D017430:Prostate-Specific Antigen / Q000097:blood*; D011471:Prostatic Neoplasms / Q000097:blood* / Q000175:diagnosis*; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity
chemical_list: D017430:Prostate-Specific Antigen