The Differential Diagnosis Value Of Prostate Specific Antigen (PSA) And Free PSA Ratio On Prostate Cancer And Benign Prostate Hyperplasia

Purpose: We aimed to analyze the diagnostic value of total prostate specific antigen(TPSA)and free PSA ratio between prostate cancer and prostate hyperplasia in Chinese population.Methods: A total of 2305 consecutive samples of outpatients and inpatients between February 2011 and October 2014 were retrospectively analyzed. We record relevant age,PSA(TPSA、FPSA)and biopsy results of these patients. Search PubMed, CNKI about PSA and the related parameters in the diagnosis of prostate cancer.The diagnostic value analysis was performed using receiver operating curve(ROC) by Medcalc 15.8 software.Results: 459 cases were excluded due to prostatitis, TPSA level ≥ 100 ng/ml, disease monitoring with prostate cancer, and any drug administration that affecting PSA level. Eventually, 150 cases of prostate cancer and 1696 cases of prostate hyperplasia were included. The results showed that PSA was significantly positively correlated with age. The optimal cutoff value of total PSA is 9.95 ng/ml, resulting in sensitivity of 0.8333, specificity of 0.7795, AUC=0.870,P<0.0001. As the PSA levels increased, the positive rate of prostate cancer increased significantly. f/t PSA had no advantage in differential diagnosis in patients with tPSA 4 to 10 ng/ml. This may be derived from the relatively small sample size of these patients. The positive rate of prostate biopsy was not significantly different between that above and inferior f/t PSA of 0.16(P = 0.80).Conclusions: This study shows that the cutoff of tPSA 10 ng/ml is suitable for Chinese population in differential diagnosis between prostate cancer and prostate hyperplasia. In 4~10 ng/ml PSA level, the differential diagnostic value of f/t PSA is poor. There is no different positive rate of biopsy above and below 0.16. Considring the sample size, larger prospective samples with 4-10 ng/ml PSA are needed for further study.