Can the Free/Total PSA Ratio Predict the Gleason Score Before Prostate Biopsy?

OBJECTIVE - To determine whether there is a correlation between high Gleason score and free/total (f/t) prostate specific antigen (PSA) in patients newly diagnosed with prostate carcinoma.

MATERIALS AND METHODS - The study included 272 prostate biopsy patients whose total PSA value ranged from 4-10 ng/ml.

The patients were divided into 2 groups according to the f/t PSA ratio: Group 1 ≤ 15% and Group 2 > 15%. Furthermore, the groups were also compared to each other in terms of mild (≤ 6), moderate (= 7), and high (≥ 8) Gleason score.

RESULTS - Group 1 consisted of 135 (49.6%) patients and Group 2 consisted of 137 (50.4%) patients. While 27 (20%) patients had a high Gleason score in Group 1, only 10 (7.3%) patients had a high Gleason score in Group 2 (p = 0.008). Using Spearman's correlation test, we found that the f/t PSA ratios were observed to decrease significantly in all patients with increased Gleason scores (p = 0.002, r = -0.185).

CONCLUSIONS - According to our study, there is a relationship between higher Gleason score and decreased f/t PSA ratio. Therefore, f/t PSA can be an indicator for predicting the Gleason score.

Current urology. 2016 Feb 10 [Epub]

Cavit Ceylan, Eymen Gazel, İbrahim Keleş, Ömer Doluoğlu, Metin Yığman

Department of Urology, Turkey Yüksek İhtisas Training and Research Hospital, Ankara, Turkey., Department of Urology, Turkey Yüksek İhtisas Training and Research Hospital, Ankara, Turkey., Department of Urology, Kocatepe University of Medicine, Afyon, Turkey., Department of Urology, Ankara Training and Research Hospital, Ankara, Turkey., Department of Urology, Turkey Yüksek İhtisas Training and Research Hospital, Ankara, Turkey.

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