The Predictive Value of Free PSA/PSAD, (F/T)/PSAD in Detect of Prostate Cancer between PSA values 4-10 mg/dl: A single-center study results

Objective: The present study aimed to investigate the predictive value of (F/T)/PSAD and Free PSA/PSAD in PCa detection in Turkish males.

Material-Methods: A retrospective analysis of patients’ files, from January 2007 to December 2017, with prostate-specific antigen (PSA) values between 4-10 ng/dl was conducted. According to the prostate biopsy outcomes, data were collected from patients and divided into prostate cancer (PCa) and/or benign prostatic hyperplasia (BPH) groups. Among the groups, prostate volume (PV), Free PSA (FPSA), Total PSA (TPSA), free-to-total PSA ratio (F/T), PSA Density (PSAD), (F/T)/PSAD, and FPSA/PSAD values were evaluated and compared. The utilization of these values in PCa detection was examined. We compared our results statistically with the ROC curve and calculated the sensitivity, specificity, PPV, and NPV values.

Results: The present study participants were 131 PCa and 196 BPH patients, 327 in total. Sensitivity and specificity values of (F/T)/PSAD and FPSA/PSAD were better than PSAD, PSA, F/T. According to the optimal cut-off value, the sensitivity of (F/T)/PSAD and FPSA/PSAD was similar. Likewise, NPV of F/T, (F/T)/PSAD, and FPSA/PSAD were also similar. The logistic regression model using a combination of age, PV, FPSA/PSAD, and (F/T)/PSAD displayed a higher AUC than each of these values per se.

Conclusion: FPSA/PSAD and (F/T)/PSAD, the relatively new parameters, have similar predictive accuracy in PCa detection. They have higher sensitivity and specificity than F/T PSA and PSAD alone. However, more research is needed to evaluate the efficiency of predictive value of these parameters.