Relation between Serum Level of Total PSA and Free PSA/Total PSA Ratio with Grade of Prostate Cancer

Document Type : Original Article (s)

Authors

1 Professor, Department of Urology, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran

2 Associate Professor, Department of Pathology, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran

3 Student of Medicine, School of Medicine AND Student Research Committee, Isfahan University of Medical Sciences, Isfahan, Iran

4 Epidemiologist, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran

Abstract

Background: One of the most common visceral cancers among men in the world is prostate cancer. Screening for early detection has a positive effect on patients’ survival time. Measurement of serum level of total PSA and free PSA is abundantly used for screening and diagnosis of prostate cancer. However, no study has been done to determine the relation between serum level of total PSA and free PSA/total PSA ratio with malignancy degree on biopsy samples. The aim of this study was to determine the relation of serum level of total PSA and free PSA/total PSA ratio, with malignancy degree.Methods: This is a cross-sectional study done in Alzahra Hospital during 2012-2013. We selected 85 patients with prostate cancer whose disease was detected in the pathology ward. Serum level of total PSA and free PSA were measured, and the degree of malignancy was determined by pathology ward based on the Gleason scoring system. All data was recorded in the questionnaire and entered into the computer and analyzed by SPSS software.Findings: The results of this study showed that there is 38% correlation between Gleason score and free PSA/total PSA ratio. Based on the Pearson correlation, this relation was statistically significant (P = 0.037). Moreover, there is a 37% relation between serum level of total PSA and the Gleason score; this relation was statistically significant (P < 0.001).   Conclusion: Prostate cancer is usually detected late and biopsy is rarely accepted by patients. Moreover, serum level of total PSA and total PSA/free PSA ratio has a relation with degree of malignancy. Therefore, serum level of PSA can help patients and physicians in early detection and treatment of prostate cancer.

Keywords


  1. Lujan M, Paez A, Llanes L, Miravalles E, Berenguer A. Prostate specific antigen density. Is there a role for this parameter when screening for prostate cancer? Prostate Cancer Prostatic Dis 2001; 4(3): 146-9.
  2. Tabibi A, Mehrabi S, Ozhand A, ZareS. Comparison of pathology and prevalence of prostate cancer in patient with PSA 4-10 ng/ml. Armaghane-danesh 2007; 12(4): 32. [In Persian].
  3. Stephan C, Xu C, Cammann H, Graefen M, Haese A, Huland H, et al. Assay-specific artificial neural networks for five different PSA assays and populations with PSA 2-10 ng/ml in 4,480 men. World J Urol 2007; 25(1): 95-103.
  4. Lang PH, Ercole CJ, Lightner DJ, Fraley EE, Vessella R. The value of serum prostate specific antigen determination before and after radical prostatectomy. J Urol 1989; 141: 873-9.
  5. Christensson A, Bjork T, Nilsson O, Dahlen U, Matikainen MT, Cockett AT, et al. Serum prostate specific antigen complexed to alpha 1-antichymotrypsin as an indicator of prostate cancer. J Urol 1993; 150(1): 100-5.
  6. Partin AW, Hanks GE, Klein EA, Moul JW, Nelson WG, Scher HI. Prostate-specific antigen as a marker of disease activity in prostate cancer. Oncology (Williston Park) 2002; 16(9): 1218-24.
  7. Baradaran A, Mahmoud Rafieian-kopaei M. Histopathological study of the combination of metformin and garlic juicefor the attenuation ofgentamicin renal toxicity in rats. J Ren Inj Prev 2012; 2(1): 15-21.
  8. Nematbakhsh M, Ashrafi F, Pezeshki Z, Fatahi Z, Kianpoor F, Sanei MH. A histopathological study of nephrotoxicity, hepatoxicity or testicular toxicity: Which one is the first observation as side effect of Cisplatin-induced toxicity in animal model? J Nephropathol 2012; 21(3):190–3.
  9. Tavafi M. Protection of renal tubules against gentamicin induced nephrotoxicity. J Ren Inj Prev 2012; 2(1): 5-6.
  10. Tavafi M. Inhibition of gentamicin – induced renal tubular cell necrosis. J Nephropathol 2012; 1(2): 83-6.
  11. Beyer DC, Thomas T, Hilbe J, Swenson V. Relative influence of Gleason score and pretreatment PSA in predicting survival following brachytherapy for prostate cancer. Brachytherapy 2003; 2(2): 77-84.
  12. Xiao Q, Yin H, Lu Z, Meng K, Zhou X. Gleason histologic grading of prostate carcinoma in relation to serum PSA, PSA in situ and immunohistochemical expression of 34 beta E12 and P504S. Zhonghua Nan Ke Xue. 2004; 10(5): 362-5. [In Chinese]
  13. Lakhatakia C, Bharadwaj C, Kumar VK, Mandal P. Immunophenotypic characterization of benign and malignant prostatic lesions. Medical Journal Armed Forces India. 2007; 63(3): 243-8.
  14. Farajian Abbasi M, Mousavi SA, Zare S. Prostate specific antigen staining intensity in prostatic adenocarcinoma correlates with serum prostate specific antigen , Bandar Abbas, Iran. Hormozgan Med J 2012; 16(5): 349-54.
  15. Vickers AJ, Cronin AM, Aus G, Pihl CG, Becker C, Pettersson K, et al. Impact of recent screening on predicting the outcome of prostate cancer biopsy in men with elevated prostate-specific antigen: data from the European Randomized Study of Prostate Cancer Screening in Gothenburg, Sweden. Cancer 2010; 116(11): 2612-20.
  16. Gheissari A. Acute kidney injury and renal angina. J Ren Inj Prev 2013; 2(2): 33-4.
  17. Nasri H. Acute kidney injury and beyond. J Ren Inj Prev 2012; 1(1): 1-2.
  18. Maghsoudi AR, Baradaran-Ghahfarokhi M, Ghaed-Amini F, Nasri H, Dehghani Mobarakeh M, Rafieian-Kopaei M. Renal failure and sub mental lymphadenopathy in a 68 years old woman. J Nephropathol 2012; 1(3): 198-201.
  19. Nasri H. Sudden onset of acute renal failure requiring di- alysis associated with large B-cell lymphoma of colon. J Nephropathology 2012; 1(3): 202-6.
  20. Kumar V, Abbas AK, Aster J. Robbins Basic Pathology. Trans. Fathollahi AR, Gooranoureimy O. Tehran, Iran: Arjmand: 2008. [In Persian].
  21. Ghorbani A. Renal protective effect of selenium on cisplatin-induced nephrotoxicity. J Ren Inj Prev 2012; 1(1): 31-2.
  22. Nasri H. Cisplatin and renal injury; current concepts. J Ren Inj Prev 2013; 2(3): 89-90.