title: [Determination of free prostatic specific antigen cut point for the selection of patients in first prostate biopsy].
abstract: OBJECTIVE
  Determine the cut point of free PSA rate for optimize the first prostate biopsy indication.
  
  
  METHODS
  Prospective trial between june 2002-september 2004, We included patients in first prostate biopsy with normal rectal digital examen, total PSA between 3-10 ng/ml and normal transrectal prostate ultrasound. We realize descriptive stadistic analisis of variables age, total PSA, prostate volume and % free PSA and analitic stadistic analisis with ROC curves of variables total PSA and % free PSA for determine as of her predicts the best one rate of prostate cancer.
  
  
  RESULTS
  We reclute 727 men with a mean age 62.91 years, total PSA mean 6.12 ng/ml, prostate volume mean 42.78 cc and % free PSA mean 15.22%. We had 106 prostate cancer, the prostate cancer rate in first biopsy was 14.6%; 77 cases had 1 lobe prostate cancer and 29 in 2 lobes. The most frecuent gleason was 6 (46 cases 43.4%) and the second gleason 7 (43 cases 40.6%). In the ROC curves analysis, total PSA had area under the curve 0.476 (p=0.3) and 0.611 (p=0.023) for % free PSA. The optime cut point for % free PSA in our trial was 19% (Sensibility 91.4% and Specificity 20%). The use of this cut point had allowed the saving us 138 biopsies (19.11%) with the lost one of diagnose of 10 cases of cancer of prostate.
  
  
  CONCLUSIONS
  The use of the % free PSA is useful and allows in our region the best indication of the patients who are going to first biopsy of prostate, avoiding the accomplishment of unnecessary biopsies.
authors.affiliation: Servicio de Urología, Hospital Regional Universitario Reina Sofia, Córdoba. allo2198@supercable.es
authors.forename: A
authors.initials: A
authors.lastname: López Luque
authors.forename: J
authors.initials: J
authors.lastname: Gómez Bermudo
authors.forename: J
authors.initials: J
authors.lastname: Márquez López
authors.forename: M
authors.initials: M
authors.lastname: Leva Vallejo
authors.forename: J C
authors.initials: JC
authors.lastname: Regueiro López
authors.forename: M J
authors.initials: MJ
authors.lastname: Requena Tapia
mesh_terms: D001706:Biopsy; D006801:Humans; D008297:Male; D008875:Middle Aged; D018579:Patient Selection; D011446:Prospective Studies; D017430:Prostate-Specific Antigen / Q000097:blood*; D011471:Prostatic Neoplasms / Q000097:blood* / Q000473:pathology*
chemical_list: D017430:Prostate-Specific Antigen