title: Can the Free/Total PSA Ratio Predict the Gleason Score Before Prostate Biopsy?
abstract: OBJECTIVE
  To determine whether there is a correlation between high Gleason score and free/total (f/t) prostate specific antigen (PSA) in patients newly diagnosed with prostate carcinoma.
  
  
  METHODS
  The study included 272 prostate biopsy patients whose total PSA value ranged from 4-10 ng/ml. The patients were divided into 2 groups according to the f/t PSA ratio: Group 1 ≤ 15% and Group 2 > 15%. Furthermore, the groups were also compared to each other in terms of mild (≤ 6), moderate (= 7), and high (≥ 8) Gleason score.
  
  
  RESULTS
  Group 1 consisted of 135 (49.6%) patients and Group 2 consisted of 137 (50.4%) patients. While 27 (20%) patients had a high Gleason score in Group 1, only 10 (7.3%) patients had a high Gleason score in Group 2 (p = 0.008). Using Spearman's correlation test, we found that the f/t PSA ratios were observed to decrease significantly in all patients with increased Gleason scores (p = 0.002, r = -0.185).
  
  
  CONCLUSIONS
  According to our study, there is a relationship between higher Gleason score and decreased f/t PSA ratio. Therefore, f/t PSA can be an indicator for predicting the Gleason score.
authors.affiliation: Department of Urology, Turkey Yüksek İhtisas Training and Research Hospital, Ankara, Turkey.
authors.forename: Cavit
authors.initials: C
authors.lastname: Ceylan
authors.affiliation: Department of Urology, Turkey Yüksek İhtisas Training and Research Hospital, Ankara, Turkey.
authors.forename: Eymen
authors.initials: E
authors.lastname: Gazel
authors.affiliation: Department of Urology, Kocatepe University of Medicine, Afyon, Turkey.
authors.forename: İbrahim
authors.initials: İ
authors.lastname: Keleş
authors.affiliation: Department of Urology, Ankara Training and Research Hospital, Ankara, Turkey.
authors.forename: Ömer
authors.initials: Ö
authors.lastname: Doluoğlu
authors.affiliation: Department of Urology, Turkey Yüksek İhtisas Training and Research Hospital, Ankara, Turkey.
authors.forename: Metin
authors.initials: M
authors.lastname: Yığman
keywords: Gleason score; PSA; Percent free PSA prostate cancer; Prostate biopsy