The Comparison Value Of Free/total PSA (f/t-PSA) And Prostate Specific Antigen Density (PSAD) In Diagnosis Of Prostate Cancer In Men With PSA Between 4ng/ml To 10ng/ml

Objective:To comparison the value of free/total PSA (f/t-PSA) and prostate specific antigen density (PSAD) in diagnosising prostate cancer when the men of serum prostate-specific antigen (PSA) levels are between 4ng/ml to 10ng/ml.Methods:From January 2010 to March 2011,there were 106 patients of prostate cancer and benign prostatic hyperplasia in this study,whose tPSA levels were between 4ng/ml to lOng/ml.The patiernts of prostate cancer or benign prostatic hyperplasia (BPH) were proved by biopsy.The PSAD and f/t-PSA are evaluated in diagnosing prostate cancer when the prostate volumes were changed.The best time of serum PSA was tested when EPS was conducted after a week, rectun examination and transrectal ultrasonography was conducted after 48 hours,and so on.Then,we could distinguish the best index to diagnosis the prostate cancer.Result:There were 40 patients of prostate cancer and 66 patients of benign prostatic hyperplasia in this study,whose tPSA levels were between 4ng/ml to 10ng/ml. Through the samples t-test,BPH patients and prostate cancer patients had significant differences in the f-PSA,f/t-PSA,prostate volume and PSAD,whlie the ages and tPSA level had no significant differences. When the cutoff of f/t ratio and PSAD were set as 0.18 and 0.15 respectively,the sentivisity and speicificity of diagnosing Prostate Cancer were different, then we can compare the diagnostic value of PSA level,free PSA/total PSA(f/t-PSA) and PSAD in detecting prostate cancer.when the volume of prostate is smaller than 40ml, The f/t-PSA of sentivisity and speicificity of diagnosing Prostate Cancer is 84.62%,88.89%; The PSAD of sentivisity and speicificity of diagnosing Prostate Cancer is 69.23%,77.78%; when the volume of prostate is bigger than 40ml, The f/t-PSA of sentivisity and speicificity of diagnosing Prostate Cancer is 71.42%,66.67%; The PSAD of sentivisity and speicificity of diagnosing Prostate Cancer is 71.43%,75.00%; when the volume of prostate is smaller than 45ml, The f/t-PSA of sentivisity and speicificity of diagnosing Prostate Cancer is 82.35%,75.00%; The PSAD of sentivisity and speicificity of diagnosing Prostate Cancer is 67.65%,72.22%; when the volume of prostate is bigger than 45ml, The f/t-PSA of sentivisity and speicificity of diagnosing Prostate Cancer is 66.67%,70.00%; The PSAD of sentivisity and speicificity of diagnosing Prostate Cancer is 83.33%,80.00%.Therefore when the volume of prostate is increased,the f/t-PSA of sentivisity and speicificity of diagnosing Prostate Cancer is decreased,while the PSAD of sentivisity and speicificity of diagnosing Prostate Cancer is increased.Conclusion:f/t-PSA and PSAD have impotrant clinical in diagnosising PCa,and f/t-PSA is related to the prostate volume,when the proetate volume was<40ml,and f/t-PSA<0.18,it has more important clinical in diagonsing PCa,while the prostate volume is bigger, PSAD has more important clinical in diagonsing PCa.