| Objectiv：To investigate the value of the serum free PSA (fPSA),the ratio of the serum freePSA to the total PSA (f/tPSA), prostate specific antigen density (PSAD), prostatespecific antigen precursor (p2PSA) and the ratio of serum prostate specific antigenprecursor to free PSA (%p2PSA) in the diagnosis of prostate cancer (PCa),when thetotal serum prostate specific antigen (tPSA) in4-10ng/ml.Methods：Retrospective analysis was performe in48cases patients with Serum tPSA in4-10ng/m,12cases confirmed prostate cancer and36cases confirmed withoutprostate cancer by biopsy.The differences of the serum tPSA, fPSA, f/tPSA, PSAD,p2PSA and%p2PSA between two group were compared, The area under the ROCcurve was used to evaluate tPSA, fPSA, f/tPSA, PSAD and p2PSA and%p2PSAdiagnostic sensitivity and specificity.Results：The difference of TPSA and PV value between the two groups were notundetected(p＝0.989and0.07),but the difference of fPSA、f/tPSA、p2PSA、PSADand%p2PSA value between the two groups were statistically significant(p＝0.017、0.04、0.04、0.03、0.001). The area under curve (ROC-AUC) of tPSA、fPSA、f/tPSA、PSAD、p2PSA and%p2PSA are:0.797,0.862,0.901,0.882,0.901and0.960，Thearea under the curve of%p2PSA significantly greater than the area under the curve oftPSA、fPSA、f/tPSA、PSAD'p2PSA（%p2PSA＞f/tPSA＞p2PSA＞PSAD＞fPSA＞tPSA）. When the cutoff point of tPSA, fPSA, f/tPSA, PSAD and p2PSA and%p2PSA were:6.4ng/ml,1.85ng/ml,0.26,0.15ng/ml/cm3,29.5pg/ml and1.95, thesensitivity and specificity were87.5%and20.9%,80.1%and40.4%,87.5%and54.2%,87.5%and50.4%,89.1%and49.6%, and90.6%and63.3%.Condusions：when total serum PSA in4-10ng/ml,%p2PSA can more significantly increase the sensitivity and specificity than tPSA、fPSA、f/tPSA、PSAD、p2PSA in thediagnosis of prostate cancer. |
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