The Free-To-Total Prostate Specific Antigen Ratio Improves the Specificity of Prostate Specific Antigen in Screening for Prostate Cancer in the General Population

Abstract

No AccessJournal of UrologyClinical Urology: Original Article1 Jun 1997The Free-To-Total Prostate Specific Antigen Ratio Improves the Specificity of Prostate Specific Antigen in Screening for Prostate Cancer in the General Population Chris H. Bangma, John B.W. Rietbergen, Ries Kranse, Bert G. Blijenberg, Kim Petterson, and Fritz H. Schroder Chris H. BangmaChris H. Bangma More articles by this author , John B.W. RietbergenJohn B.W. Rietbergen More articles by this author , Ries KranseRies Kranse More articles by this author , Bert G. BlijenbergBert G. Blijenberg More articles by this author , Kim PettersonKim Petterson More articles by this author , and Fritz H. SchroderFritz H. Schroder More articles by this author View All Author Informationhttps://doi.org/10.1016/S0022-5347(01)64712-8AboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract Purpose: The ratio between free and total prostate specific antigen (PSA) in serum improves the specificity of total serum PSA for the detection of prostate carcinoma in select populations. The value of the free-to-total PSA ratio for a PSA of 4.0 to 10.0 ng./ml. was analyzed in a screening population. Materials and Methods: From 4,800 participants 55 to 76 years old 977 biopsies were obtained because of an abnormal digital rectal examination, suspicious transrectal ultrasonography and total serum PSA 4.0 ng./ml. or more. Of 191 patients with prostate carcinoma detected 101 had a serum PSA of 4.0 to 10.0 ng./ml. and 54 of them underwent radical prostatectomy. A free-to-total PSA ratio of 0.20, age specific PSA reference ranges and a PSA density of 0.12 ng./ml./cc were evaluated for the ability to increase the specificity of total serum PSA in predicting positive prostate biopsy results. Results: Receiver operating characteristics curves for the free-to-total PSA ratio showed a significant increase in specificity compared to PSA. Retrospective application of age specific PSA reference ranges, the free-to-total PSA ratio and the PSA density decreased the number of biopsies significantly by up to 40% in our study, with a decrease in cancer detection rate of 12%. When used in combination with digital rectal examination, the pathological stage of undetected carcinomas appeared favorable. Conclusions: The free-to-total PSA ratio may be used to decrease biopsies in patients with an intermediate PSA of 4.0 to 10.0 ng./ml. References 1 : The American Cancer Society National Prostate Cancer Detection Project. 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Google Scholar From the Departments of Urology and Clinical Chemistry, Academic Hospital Rotterdam, Rotterdam, The Netherlands, and Department of Biotechnics, Turku University, Turku, Finland.© 1997 by American Urological Association, Inc.FiguresReferencesRelatedDetailsCited Byde la Taille A, Irani J, Graefen M, Chun F, de Reijke T, Kil P, Gontero P, Mottaz A and Haese A (2018) Clinical Evaluation of the PCA3 Assay in Guiding Initial Biopsy DecisionsJournal of Urology, VOL. 185, NO. 6, (2119-2125), Online publication date: 1-Jun-2011.RAAIJMAKERS R, BLIJENBERG B, FINLAY J, RITTENHOUSE H, WILDHAGEN M, ROOBOL M and SCHRÖDER F (2018) PROSTATE CANCER DETECTION IN THE PROSTATE SPECIFIC ANTIGEN RANGE OF 2.0 TO 3.9 NG/ML: VALUE OF PERCENT FREE PROSTATE SPECIFIC ANTIGEN ON TUMOR DETECTION AND TUMOR AGGRESSIVENESSJournal of Urology, VOL. 171, NO. 6 Part 1, (2245-2249), Online publication date: 1-Jun-2004.MÄKINEN T, TAMMELA T, HAKAMA M, STENMAN U, RANNIKKO S, ARO J, JUUSELA H, MÄÄTTÄNEN L and AUVINEN A (2018) PROSTATE CANCER SCREENING WITHIN A PROSTATE SPECIFIC ANTIGEN RANGE OF 3 TO 3.9 NG./ML.: A COMPARISON OF DIGITAL RECTAL EXAMINATION AND FREE PROSTATE SPECIFIC ANTIGEN AS SUPPLEMENTAL SCREENING TESTSJournal of Urology, VOL. 166, NO. 4, (1339-1342), Online publication date: 1-Oct-2001.EMILIOZZI P, LONGHI S, SCARPONE P, PANSADORO A, DePAULA F and PANSADORO V (2018) THE VALUE OF A SINGLE BIOPSY WITH 12 TRANSPERINEAL CORES FOR DETECTING PROSTATE CANCER IN PATIENTS WITH ELEVATED PROSTATE SPECIFIC ANTIGENJournal of Urology, VOL. 166, NO. 3, (845-850), Online publication date: 1-Sep-2001.ROBERTS R, BERGSTRALH E, PETERSON N, BOSTWICK D, LIEBER M and JACOBSEN S (2018) POSITIVE AND NEGATIVE BIOPSIES IN THE PRE-PROSTATE SPECIFIC ANTIGEN AND PROSTATE SPECIFIC ANTIGEN ERAS, 1980 TO 1997Journal of Urology, VOL. 163, NO. 5, (1471-1475), Online publication date: 1-May-2000.DJAVAN B, ZLOTTA A, REMZI M, GHAWIDEL K, BASHARKHAH A, SCHULMAN C and MARBERGER M (2018) OPTIMAL PREDICTORS OF PROSTATE CANCER ON REPEAT PROSTATE BIOPSY: A PROSPECTIVE STUDY OF 1,051 MENJournal of Urology, VOL. 163, NO. 4, (1144-1149), Online publication date: 1-Apr-2000.DJAVAN B, ZLOTTA A, BYTTEBIER G, SHARIAT S, OMAR M, SCHULMAN C and MARBERGER M (2018) PROSTATE SPECIFIC ANTIGEN DENSITY OF THE TRANSITION ZONE FOR EARLY DETECTION OF PROSTATE CANCERJournal of Urology, VOL. 160, NO. 2, (411-418), Online publication date: 1-Aug-1998. Volume 157Issue 6June 1997Page: 2191-2196 Advertisement Copyright & Permissions© 1997 by American Urological Association, Inc.MetricsAuthor Information Chris H. Bangma More articles by this author John B.W. Rietbergen More articles by this author Ries Kranse More articles by this author Bert G. Blijenberg More articles by this author Kim Petterson More articles by this author Fritz H. Schroder More articles by this author Expand All Advertisement PDF DownloadLoading ...