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The influence of prostate volume on the ratio of free to total prostate specific antigen in serum of patients with prostate carcinoma and benign prostate hyperplasia

  1. Carsten Stephan M.D.,
  2. Michael Lein M.D.,
  3. Klaus Jung M.D.*,
  4. Dietmar Schnorr M.D.,
  5. Stefan A. Loening M.D.

Article first published online: 27 SEP 2000

DOI: 10.1002/(SICI)1097-0142(19970101)79:1<104::AID-CNCR15>3.0.CO;2-8

Issue

Cancer

Cancer

Volume 79, Issue 1, pages 104–109, 1 January 1997

Additional Information

How to Cite

Stephan, C., Lein, M., Jung, K., Schnorr, D. and Loening, S. A. (1997), The influence of prostate volume on the ratio of free to total prostate specific antigen in serum of patients with prostate carcinoma and benign prostate hyperplasia. Cancer, 79: 104–109. doi: 10.1002/(SICI)1097-0142(19970101)79:1<104::AID-CNCR15>3.0.CO;2-8

Author Information

  1. Department of Urology, University Hospital Charité, Humboldt University Berlin, Berlin, Germany

*Department of Urology, University Hospital Charité, Humboldt University Berlin, Schumannstraße 20/21, 10098 Berlin, Germany

Publication History

  1. Issue published online: 27 SEP 2000
  2. Article first published online: 27 SEP 2000
  3. Manuscript Accepted: 30 AUG 1996
  4. Manuscript Revised: 15 AUG 1996
  5. Manuscript Received: 1 MAY 1996

Funded by

  • Foundation of the Klee family (Michael Lein) and from the Fonds der Chemischen Industrie (Klaus Jung, project no. 400700)

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Keywords:

  • prostate carcinoma;
  • benign prostate hyperplasia;
  • prostate volume;
  • prostate specific antigen;
  • ratio of free to total prostate specific antigen;
  • diagnostic validity

The ratio of free to total prostate specific antigen in serum of patients with prostate carcinoma is influenced by prostate volume. This ratio allows for differentiation between prostate carcinoma and benign prostate hyperplasia only when the volume of the prostate gland is less than 40 cm3.

Abstract

BACKGROUND

Determining the ratio of free to total prostate specific antigen (f-PSA to t-PSA, calculated as the percentage of f-PSA [f-PSA%]) in serum allows for a clearer distinction between patients with prostate carcinoma (PCa) and patients with benign prostate hyperplasia (BPH) than determining the level of t-PSA alone. To find influencing factors on f-PSA%, the authors investigated prostate volume, TNM classification, and tumor stage.

METHODS

The authors measured f-PSA and t-PSA in 36 men with untreated PCa (tumor classification: T1, 2, 3pN0, M0), 44 patients with BPH, and 54 healthy controls. Prostate volume was determined by transrectal ultrasound.

RESULTS

The median values of t-PSA and f-PSA% were 7.8 μg/L and 10.5% in PCa patients, 4.3 μg/L and 20.8% in patients with BPH, and 1.4 μg/L and 23.6% in the control group. Patients with PCa had a significantly lower proportion of f-PSA than BPH patients and healthy men. There was no correlation of f-PSA% to TNM stage or tumor grade. In PCa patients a significant positive correlation (correlation coefficient [r] = 0.51, P < 0.001) was found between f-PSA% and prostate volume, whereas there was no significant correlation in BPH patients (r = -0.27, P > 0.05). There was a significant difference in f-PSA% between PCa and BPH patients with prostate volumes smaller than 40 cm3 (9.0% vs. 21.6%, P < 0.01) but not between patients in these 2 groups with prostate volumes exceeding 40 cm3 (15.1% vs. 18.2%, P = 0.11).

CONCLUSIONS

Determining the ratio of f-PSA to t-PSA to discriminate between PCa and BPH patients yields significant results only in men with a prostate volume of less than 40 cm3. Cancer 1997; 79:104-9. © 1997 American Cancer Society.

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