scholarly journals Role of Serum Total PSA (Prostate Specific Antigen) and Free to Total PSA Ratio in the Diagnosis of Carcinoma Prostate

2013 ◽  
Vol 4 (1) ◽  
pp. 21-26
Author(s):  
S Ferdousi ◽  
MA Alim ◽  
Z Ferdous ◽  
A Khatun ◽  
N Sultana ◽  
...  
Keyword(s):  
Prostate Specific Antigen ◽  
Prostatic Carcinoma ◽  
Specific Antigen ◽  
Total Serum ◽  
Serum Prostate Specific Antigen ◽  
Medical College ◽  
Carcinoma Prostate ◽  
Total Psa ◽  
Total Ratio

The objective of the study was to evaluate and compare the role of total and free/total ratio of serum prostate specific antigen level in diagnosing carcinoma prostate. A cross sectional study was conducted at the Department of Biochemistry, Dhaka Medical College (DMC) with collaboration of the Department of Urology, Dhaka Medical College Hospital (DMCH), Dhaka from July 2008 to June 2009. This study was carried out on 60 patients above 50 years of age who attended the Department of Urology, Dhaka Medical College Hospital, complaining of irritative or obstructive lower urinary tract symptoms (LUTS) suspected as clinically benign prostatic hyperplasia (BPH) or cancer prostate. It was aimed to assess the role of total and free/total ratio of serum PSA in diagnosis of BPH and carcinoma prostate with reference to histological diagnosis. All the cases were evaluated by history, physical examination including digital rectal examination, serum prostate specific antigen level, transabdominal/ trans-rectal ultra- sonogram. From all patients, blood sample were collected before digital rectal examination or any per urethral manipulation. Final diagnosis was obtained by histo-pathological examination, specimen being obtained by perrectal biopsy with biopsy-gun. Histopathological examination detected prostate cancer in 20 out of 60 patient and 17 of these Cap 20 have a total PSA ? 4 ng/ml and only 3 have total PSA ? 4 ng/ml. 18 of these 20 have free to total ratio ?0.16 and 02 have f/t ratio ?0.16. Among 60 patients, 40 patients were detected BPH on histopathological diagnosis. 20 of these BPH patient have tPSA ? 4 ng/ml and 20 of BPH have tPSA ? 4 ng/ml. 38 of 40 BPH patient have f/t ratio >0.16 and 2 of 40 patient are f/t ratio ?0.16. Receiver operating characteristic analysis indicated a threshold f/t ratio ? 0.16 was optimum discriminatory level. The sensitivity of total serum PSA (at cut off value of >4 ng/ml) in correctly differentiating prostatic carcinoma of those who have the condition is 85%, while the specificity of the test in correctly detecting those who do not have the disease is 50%. The PPV is 45.9%, NPV is 87% and accuracy is 61.7%. The sensitivity of free/total serum PSA (at cut off value of 0.16 ng/ml) in correctly differentiating prostatic carcinoma from BPH is 90%, while the specificity of the test in correctly detecting those who do not have prostatic carcinoma is 95%. The PPV of the test is 90% and the NPV of the test is 95%. The overall accuracy of the test is 93.3%. This study showed significant difference of total and free/total ratio of serum prostate specific antigen (PSA) in differentiating benign prostatic hyperplasia (BPH) from carcinoma prostate. Receiver operating characteristic curves showed advantage for the f/t PSA ratio when compared with total PSA in detecting prostate cancer. From the study it may be concluded that total and f/t ratio of prostate specific antigen (PSA) is a useful marker in diagnosis of carcinoma prostate. Free/total ratio is more accurate than total PSA. DOI: http://dx.doi.org/10.3329/bjmb.v4i1.13778 Bangladesh J Med Biochem 2011; 4(1): 21-26

scholarly journals SERUM PROSTATE SPECIFIC ANTIGEN (PSA);

2012 ◽  
Vol 20 (01) ◽  
pp. 017-022
Author(s):  
ZEHRA NAZ ◽  
SAADIA ANJUM, ◽  
MEHDI RAZA
Keyword(s):  
Prostate Specific Antigen ◽  
Specific Antigen ◽  
Age Groups ◽  
Normal Subjects ◽  
Serum Prostate Specific Antigen ◽  
Reductase Inhibitors ◽  
Carcinoma Prostate ◽  
Significant Difference ◽  
Data Source ◽  
Total Psa

ABSTRACT… Objective: To study correlation between age-linked serum prostate specific antigen (PSA) levels in normal subjects andpatients of benign prostatic hyperplasia (BPH) and carcinoma prostate (CaP). Data source: OPDs. Study design: Case-control study.Setting: SIUT; Karachi Study duration: Six months. Methodology: 250 subjects were enrolled for the study and 93 were finally selected(31 each, representing the normal, BPH and CaP groups). Subjects 40 years of age and above were included and those with any urinarytract disorder or those under treatment with 5-á-reductase inhibitors were excluded. Each group was divided into four sub-groups of ages40 – 49, 50 – 59, 60 – 69 and 70 and above years. AxSYM total PSA (tPSA) assay® was used for serum PSA estimation. Values wereexpressed as mean and standard error of mean and Fischer’s test, students’ t test and correlation coefficient were used to determinesignificance and for comparison of data. Results: There was a no significant difference in PSA levels in all age groups when normals werecompared with BPH cases. PSA levels were significant in normal as compared to CaP cases and BPH as compared to CaP. Conclusions:No significant correlation between age-linked serum PSA levels in normal subjects and patients of BPH and CaP could be established. Thestudy, however, found a trend of declining PSA levels at the age of 70 years and above.

scholarly journals Disagreement between the Roche Cobas® Core and Hybritech TANDEM®-E PSA Assays When Measuring Free, Complexed and Total Serum Prostate Specific Antigen

1994 ◽  
Vol 31 (5) ◽  
pp. 501-505 ◽  
Author(s):  
Colin R Tillyer ◽  
Monique Konings ◽  
Philip T Gobin ◽  
Jahangir Iqbal
Keyword(s):  
Prostate Specific Antigen ◽  
Prostatic Carcinoma ◽  
Specific Antigen ◽  
Tumour Marker ◽  
Clinical Development ◽  
Free Form ◽  
Total Serum ◽  
Serum Prostate Specific Antigen ◽  
Universal Standard ◽  
Roche Cobas

A comparison of the Roche Cobas® Core and Hybritech TANDEM®-E PSA (prostate specific antigen) assays revealed a large difference in the reactivity of each assay to the separated free and complexed forms of serum PSA in patients with prostatic carcinoma. The Roche assay was relatively much more responsive to the free form, but the Hybritech assay was relatively more responsive to the complexed form and total serum PSA. It is possible that the adoption of a universal standard for PSA will not completely resolve the disagreement between PSA assay on individual patient samples, and the use of separate assays for the free and complexed forms may be necessary for the further clinical development of PSA as a tumour marker.

scholarly journals The Combination of Human Glandular Kallikrein and Free Prostate-specific Antigen (PSA) Enhances Discrimination Between Prostate Cancer and Benign Prostatic Hyperplasia in Patients with Moderately Increased Total PSA

1999 ◽  
Vol 45 (11) ◽  
pp. 1960-1966 ◽  
Author(s):  
Angeliki Magklara ◽  
Andreas Scorilas ◽  
William J Catalona ◽  
Eleftherios P Diamandis
Keyword(s):  
Prostate Cancer ◽  
Benign Prostatic Hyperplasia ◽  
Prostate Specific Antigen ◽  
Prostatic Carcinoma ◽  
Specific Antigen ◽  
Area Under The Curve ◽  
Prostatic Hyperplasia ◽  
Free Psa ◽  
Glandular Kallikrein ◽  
Total Psa

Abstract Background: Prostate-specific antigen (PSA) is the most reliable tumor marker available and is widely used for the diagnosis and management of prostate cancer. Unfortunately, PSA cannot distinguish efficiently between benign and malignant disease of the prostate, especially within the range of 4–10 μg/L. Among the refinements developed to enhance PSA specificity is the free/total PSA ratio, which is useful in discriminating between the two diseases within the diagnostic “gray zone”. Recent data indicate that human glandular kallikrein (hK2), a protein with high homology to PSA, may be an additional serum marker for the diagnosis and monitoring of prostate cancer. Methods: We analyzed 206 serum samples (all before treatment was initiated) from men with histologically confirmed benign prostatic hyperplasia (n = 100) or prostatic carcinoma (n = 106) with total PSA in the range of 2.5–10 μg/L. Total and free PSA and hK2 were measured with noncompetitive immunological procedures. Statistical analysis was performed to investigate the potential utility of the various markers or their combinations in discriminating between benign prostatic hyperplasia and prostatic carcinoma. Results: hK2 concentrations were not statistically different between the two groups of patients. There was a strong positive correlation between hK2 and free PSA in the whole patient population. hK2/free PSA ratio (area under the curve = 0.69) was stronger predictor of prostate cancer than the free/total PSA ratio (area under the curve = 0.64). At 95% specificity, the hK2/free PSA ratio identified 30% of patients with total PSA between 2.5–10 μg/L who had cancer. At 95% specificity, the hK2/free PSA ratio identified 25% of patients with total PSA between 2.5 and 4.5 μg/L who had cancer. Conclusions: Our data suggest that hK2 in combination with free and total PSA can enhance the biochemical detection of prostate cancer in patients with moderately increased total PSA concentrations. More specifically, the hK2/free PSA ratio appears to be valuable in identifying a subset of patients with total PSA between 2.5 and 4.5 μg/L who have high probability of cancer and who should be considered for biopsy.

Free, Complexed and Total Serum Prostate Specific Antigen

1995 ◽  
pp. 1090-1095 ◽  
Author(s):  
Joseph E. Oesterling ◽  
Steven J. Jacobsen ◽  
George G. Klee ◽  
Kim Petterson ◽  
Timo Piironen ◽  
...  
Keyword(s):  
Prostate Specific Antigen ◽  
Specific Antigen ◽  
Total Serum ◽  
Serum Prostate Specific Antigen
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