OBJECTIVE: To analyse the ratio of serum testosterone (sT) to prostate-specific antigen (PSA) as a predictor of prostate cancer risk, as low levels of sT have been related to a greater risk of prostate cancer, and its ratio with serum PSA level was recently proposed as a new tool to increase the specificity of PSA. PATIENTS AND METHODS: In all, 439 consecutive men with a normal digital rectal examination and a serum PSA level of 4.1-20 ng/mL had a transrectal ultrasonography-guided biopsy using a 10-core scheme, with an additional 1-8 cores according to prostate volume and patient age. The sT level was determined before the procedure using a chemiluminescent assay, and the ratio of sT to PSA (sT/PSA) was calculated after transforming sT measurements from ng/dL to ng/mL. The percentage free PSA (%fPSA) and PSA density were also included in this analysis. RESULTS: The overall cancer detection rate was 42.1%. The median sT level was 469 ng/dL in men with cancer and 499 ng/dL in those without (P = 0.521). The median sT/PSA was 0.68 and 0.74, respectively (P = 0.215). However, the median %fPSA was 14 in men with cancer and 17 in men without (P < 0.001) and the median PSA density was 0.22 and 0.16, respectively (P < 0.001). The multivariate analysis confirmed the independent predictive value only for %fPSA (odds ratio 0.94, 95% confidence interval 0.91-0.98) and PSA density (5.8, 3.42-19.8). CONCLUSION: These results do not support the use of sT/PSA for predicting the risk of prostate cancer and to increase the specificity of PSA.
OBJECTIVE: To analyse the ratio of serum testosterone (sT) to prostate-specific antigen (PSA) as a predictor of prostate cancer risk, as low levels of sT have been related to a greater risk of prostate cancer, and its ratio with serum PSA level was recently proposed as a new tool to increase the specificity of PSA. PATIENTS AND METHODS: In all, 439 consecutive men with a normal digital rectal examination and a serum PSA level of 4.1-20 ng/mL had a transrectal ultrasonography-guided biopsy using a 10-core scheme, with an additional 1-8 cores according to prostate volume and patient age. The sT level was determined before the procedure using a chemiluminescent assay, and the ratio of sT to PSA (sT/PSA) was calculated after transforming sT measurements from ng/dL to ng/mL. The percentage free PSA (%fPSA) and PSA density were also included in this analysis. RESULTS: The overall cancer detection rate was 42.1%. The median sT level was 469 ng/dL in men with cancer and 499 ng/dL in those without (P = 0.521). The median sT/PSA was 0.68 and 0.74, respectively (P = 0.215). However, the median %fPSA was 14 in men with cancer and 17 in men without (P < 0.001) and the median PSA density was 0.22 and 0.16, respectively (P < 0.001). The multivariate analysis confirmed the independent predictive value only for %fPSA (odds ratio 0.94, 95% confidence interval 0.91-0.98) and PSA density (5.8, 3.42-19.8). CONCLUSION: These results do not support the use of sT/PSA for predicting the risk of prostate cancer and to increase the specificity of PSA.
Authors: Eduard García-Cruz; Jorge Huguet; Marta Piqueras; Meritxell Pérez Márquez; Lluís Peri; Laura Izquierdo; Agustín Franco; Ricardo Alvarez-Vijande; María José Ribal; Antonio Alcaraz Journal: World J Urol Date: 2011-08-11 Impact factor: 4.226
Authors: E David Crawford; Axel Heidenreich; Nathan Lawrentschuk; Bertrand Tombal; Antonio C L Pompeo; Arturo Mendoza-Valdes; Kurt Miller; Frans M J Debruyne; Laurence Klotz Journal: Prostate Cancer Prostatic Dis Date: 2018-08-21 Impact factor: 5.554