Clinical Significance Of Serum TPSA, FPSA/tPSA And PSAD In The Differential Diagnosis Of Benign And Malignant Prostatic Diseases

OBJECTIVE: To study significance of serum total prostate-specific antigen (tPSA) , the ratio of free to total prostate specific antigen(F/T) and prostate specific antigen density(PSAD) in the differential diagnosis of benign and malignant prostatic diseases.METHODS: I analysed retrospectively the tPSA,fPSA and prostatic volume in 38 prostate cancer and 65 BPH patients who were diagnosed and treated in QiLu Hospital of Shandong university from March 2001 to December 2004. F/T ratio and PSAD were obtained. The tPSA ,F/T ratio and PSAD in patients both within and outside the gray zone were analyzed.RESULTS: (1)Total PSA and PSAD were significantly different between patients with prostate cancer and BPH (P<0.01 both) when the assessed value were much higher beyond gray zone. (2)When the assessed value were within the gray zone , tPSA could not serve as a differential marker for the two conditions(P>0.05) whereas F/T and PSAD could( P<0. 01 both) . (3)However , tPSA , F/T ,and PSAD had no significant differences between the two conditions (P>0. 05) in the lower value range beyond the gray zone.CONCLUSION: The f/tPSA and PSAD which are adjuvant markers to tPSA, have clinical significance in the differential diagnosis in patients whose tPSA in diagnostic gray zone.