Sajjad Ahmad, Abdul Ghafar, Ghazi Khan


Background: Prostate-specific antigen (PSA) is a tumor marker helpful in the diagnosis and follow-up of prostate cancer. Objective of the study was to determine Free/total PSA ratio as a predictor of prostate carcinoma.
Material and Methods: This cross-sectional study was carried in the Department of Histopathology, Shaikh Zayed Hospital, Lahore during December, 2006 to July, 2007. Hundred patients were asked to consent for blood sample for PSA analysis. The prostate tissue was preserved in fixative solution (10% buffered) neutral formalin. Multiple sections were stained with Haematoxylin and Eosin and examined microscopically. The demographic variable was age. The research variables were fPSA/tPSA ratio, morphology of prostate, tPSA and fPSA. Frequency and percentage were calculated for categorical whereas mean and standard deviation (SD) for numeric variables. The findings were recorded in proforma. Histopathology was taken as gold standard. The data was entered in SPSS version 10 and analyzed accordingly.
Results: Mean TPSA was found to be higher in carcinoma cases (25.7±21.6 ng/mL) and was lower in the benign cases (12.7±6.9 ng/mL). Moreover, a majority of the carcinoma cases had serum PSA >10 ng/mL. Using a free-PSA “cut-off” of 25% to differentiate between benign and malignant prostate enlargement.
Conclusion: This study concludes that there is highly significant increase in tPSA level in cases of prostate carcinoma whereas fPSA/tPSA ratio significantly increases in BPH cases as compared to prostate carcinoma. Therefore fPSA/tPSA ratio can be a useful predictor for early detection of prostate carcinoma.


Free prostate- specific antigen; Prostate; carcinoma.

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