Abstract
Article History Objectives: The aim of this study is to evaluate the use of F/TPSA ratio to improve differentiation of Prostate Cancer from Benign Prostatic Hyperplasia in Sudanese patients in Khartoum state. Methods: A prospective, analytical, hospital based, Case control study. This study was carried out in Fedail Medical Hospital during the period of 2010 to 2012. This study was performed on 200 patients as study group and 100 healthy volunteer as control group. Serum levels of TPSA and FPSA were measured by Roche immunoassay e411. Results: Detection rate of PCa for serum TPSA level 4- 10 ng/ml and serum TPSA level of 10 to 20 ng/ml was (32%) and (54%), respectively. Mean F/TPSA ratio value was significantly lower in PCa patients (16 ± 9ng/ml) than in BPH group (30±7g/ml). Among patients with serum PSA level of 4 to 10 ng/ml (n = 93), mean F/TPSA ratio in BPH group (n =63) was (32 ± 5) and in PCa group (n = 30) was (14 ±5) (P <0.001). For serum PSA level of 10-20 ng/ml (n = 43), mean F/TPSA ratio in BPH group (n = 18) was (25 ±7) and in PCa group (n = 25) was (16 ± 9) (P <0 .001). Conclusion: Determination of F/TPSA ratio improves differentiation of PCa from BPH. This study recommends a cut-off value of 18% to be applied to Sudanese patients.
Highlights
Prostate cancer is the second leading cause of cancer-related deaths for men in the United States (Jemal et al 2007), and the first genitourinary tract cancer (Al-Samawi and Aulaqi 2013)
Thereafter, serum FPSA and TPSA were measured; the Free to total prostate-specific antigen (PSA) ratio was calculated from dividing FPSA by TPSA and multiply by100
Serum TPSA (6±2ng/ml) in the PCa group was higher than that (6±1ng/ml) in benign prostatic hyperplasia (BPH) group but no significance was achieved (p>0.050)
Summary
Prostate cancer is the second leading cause of cancer-related deaths for men in the United States (Jemal et al 2007), and the first genitourinary tract cancer (Al-Samawi and Aulaqi 2013). The Food and Drug Administration (FDA) in 1994, approved serum PSA to be used as an early detection of prostate cancer. In men with prostate cancer, the serum levels can be elevated in both localized and advanced or disseminated disease. There is a significant overlap between PSA levels found in cancer and benign prostatic hyperplasia (BPH) cases (Carter et al 1997). The introduction of free PSA (FPSA) testing has introduced a greater level of specificity in identifying early prostate cancer (Catalona et al 2000, American Urological Association). In 1998, the FDA approved FPSA testing as a diagnostic aid for men with total PSA (TPSA) values between 4-10 ng/ml. In men without prostatic cancer, the ratio of FPSA / TPSA is more than 25%. A ratio of less than 25% is found in men with prostatic adenocarcinoma (Lilja and Stenman 1996)
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