title: Urinary/serum prostate-specific antigen ratio: comparison with free/total serum prostate-specific antigen ratio in improving prostate cancer detection.
abstract: OBJECTIVE
  To test the previously reported hypothesis, that the urinary/total serum (U/S) prostate-specific antigen (PSA) ratio improves the detection of prostate cancer, by evaluating the clinical usefulness of the U/S PSA ratio and comparing it with the free/total (F/T) serum PSA ratio.
  
  
  METHODS
  A total of 165 patients undergoing transrectal ultrasound-guided prostate biopsy were prospectively included in this multicenter study. In all patients, PSA was measured from preoperative serum and 12-hour urine specimens in a centralized laboratory.
  
  
  RESULTS
  Prostate cancer was identified in 83 of 165 patients. The differences between patients with and without prostate cancer were statistically significant (P <0.001) when considering the total PSA value (median, 10.2 ng/mL and 6.6 ng/mL respectively), F/T serum PSA ratio (0.11 and 0.18), and U/S PSA ratio (1.2 and 4.2). In the group of 79 patients with a PSA level between 4 and 10 ng/mL, receiver operating characteristic curves showed that the U/S PSA ratio was associated with a larger area under the curve (0.63; 95% confidence interval, 0.51 to 0.73) than the total PSA value (0.55; 95% confidence interval, 0.43 to 0.66) or F/T serum PSA ratio (0.60; 95% confidence interval, 0.49 to 0.71). The U/S PSA ratio did not correlate with patient age or prostate volume.
  
  
  CONCLUSIONS
  Our results confirmed that the U/S PSA ratio may be a useful test in prostate cancer detection when the total serum PSA level is between 4 and 10 ng/mL. The F/T serum PSA ratio and U/S PSA ratio did not correlate. This suggests that these two tests could complement each other.
authors.affiliation: Department of Urology, Poitiers University Hospital, Poitiers, France. j.irani@chu-poitiers.fr
authors.forename: Jacques
authors.initials: J
authors.lastname: Irani
authors.forename: Laurent
authors.initials: L
authors.lastname: Salomon
authors.forename: Michel
authors.initials: M
authors.lastname: Soulié
authors.forename: Alexandre
authors.initials: A
authors.lastname: Zlotta
authors.forename: Alexandre
authors.initials: A
authors.lastname: de la Taille
authors.forename: Bertrand
authors.initials: B
authors.lastname: Doré
authors.forename: Christine
authors.initials: C
authors.lastname: Millet
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001706:Biopsy; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D017430:Prostate-Specific Antigen / Q000097:blood* / Q000652:urine*; D011471:Prostatic Neoplasms / Q000097:blood / Q000175:diagnosis* / Q000652:urine; D015203:Reproducibility of Results
chemical_list: D017430:Prostate-Specific Antigen