Comparison of the clinical value of complexed PSA and total PSA in the discrimination between benign prostatic hyperplasia and prostate cancer.
BACKGROUND
To compare the clinical value of the measurement of complex and total PSA in the discrimination between benign prostatic hyperplasia (BPH) and prostate cancer.


METHODS
In serum samples collected from 166 men with histopathologically proven clinically localized prostate cancer and of 97 men with BPH, total prostate-specific antigen (PSA), complexed PSA and the free to total PSA ratio were determined. The statistical analysis was done by the comparison of the receiver operator characteristic (ROC) curves.


RESULTS
The areas under the ROC curves were 0.776 for total PSA, 0.799 for complexed PSA (total PSA vs. cPSA: p < 0.0001) and 0.812 for the free to total PSA ratio. With a cut-off of 3.0 ng/ml for complexed PSA, the sensitivity was 90%, the specificity 58%, the positive and the negative predictive values 79 and 78%, respectively. With a cut-off of 4.0 ng/ml for total PSA, the sensitivity was 87%, the specificity 59%, the positive and the negative predictive values were 78 and 72%, respectively.


CONCLUSIONS
There was a statistically significant advantage for complexed PSA compared to total PSA in the discrimination between BPH and prostate cancer. The difference was, however, small and its clinical relevance is questionable.
Froehner
Michael
M
Department of Urology, University Hospital Carl Gustav Carus, Technical University of Dresden, Dresden, Germany. Michael.Froehner@uniklinikum-dresden.de
Hakenberg
Oliver W
OW
Koch
Rainer
R
Schmidt
Uta
U
Meye
Axel
A
Wirth
Manfred P
MP
D003937:Diagnosis, Differential; D006801:Humans; D008297:Male; D017430:Prostate-Specific Antigen / Q000097:blood*; D011470:Prostatic Hyperplasia / Q000097:blood* / Q000175:diagnosis*; D011471:Prostatic Neoplasms / Q000097:blood* / Q000175:diagnosis*
D017430:Prostate-Specific Antigen