TPSA, FPSA , and ratio of FPSA/TPSA for diagnosing prostate carcinoma

Abstract

Objective To investigate the clinical significance of total prostate-specific antigen (TPSA),free prostate specific antigen (FPSA),and the ratio of FPSA/TPSA for diagnosing prostate carcinoma (PCa).Methods 115 patients with PCa and 143 patients with benign prostate hyperplasia (BPH) diagnosed by the pathological biopsy of prostate were collected.Their serum TPSA and FPSA levels were detected by chemiluminescent microparticle immunoassay (CMIA) technology.Taking FPSA/TPSA ＜ 0.18 as the cut off value,the accuracy rate differences of the same level of TPSA between the PCa and BPH patients were analyzed and the sensitivities,specificities,positive predictive values,and negative predictive values of FPSA/ TPSA for diagnosing PCa were calculated when the levels of TPSA ranged 4.0-10.0 μ g/L,10.0-50.0 μ g/L,and ＞ 50.0 μg/L,respectively.Results Taking FPSUTPSA ＜ 0.18 as the cut off value,when the level of TPSA ranged from 4.0 to 10.0 μ g/L,there was no statistical difference in diagnosis accuracy rate between BPH and PCa patients (P ＞ 0.05); when the level of TPSA ranged form 10.0 to 50.0 μg/L or ＞ 50.0 μg/L,there were statistical differences in diagnosis accuracy rate between BPH and PCa patients (P ＜ 0.005).The higher the level of TPSA was,the more accurately PCa could be diagnosed bv FPSA/TPSA and there was statistical difference (P ＜ 0.05).The sensitivities were 46.67％,67.39％,and 89.74％,the specificities were 66.00％,84.44％,and 72.22％,the positive predictive values were 45.16％,81.58％,and 87.50％,and the negative predictive values were 67.35％,71.70％,and 76.47％ when the levels of TPSA ranged 4.0-10.0 μ g/L,10.0-50.0 μ g/ L,and ＞ 50.0 μ g/L,respectively.Conclusions The higher the level of TPSA is,the more accurately PCa could be diagnosed bv FPSA/TPSA.It suggests that TPSA,FPSA,and the ratio of FPSA/TPSA can be used as a reference index for diagnosing PCa. Key words: Prostate-specific antigen; Prostate carcinoma; Diagnosis