Performance of free prostate-specific antigen ratio in differentiating between prostatic cancer and benign prostatic lesions at a referral hospital in South Africa
Background: Prostate cancer is a leading cause of morbidity and mortality in our male population, thus screening initiatives will help to improve outcomes. The current screening marker, total prostate-specific antigen (PSA), is not prostate cancer specific. The development of percentage free PSA (%F...
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| Language: | English |
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AOSIS
2018-08-01
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| Series: | South African Family Practice |
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| Online Access: | https://safpj.co.za/index.php/safpj/article/view/4889 |
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| author | Boitumelo Phiri-Ramongane Ayeaye Khine |
| author_facet | Boitumelo Phiri-Ramongane Ayeaye Khine |
| author_sort | Boitumelo Phiri-Ramongane |
| collection | DOAJ |
| description | Background: Prostate cancer is a leading cause of morbidity and mortality in our male population, thus screening initiatives will help to improve outcomes. The current screening marker, total prostate-specific antigen (PSA), is not prostate cancer specific. The development of percentage free PSA (%FPSA) has largely improved the detection of prostate cancer.
Objectives: To assess the performance of %FPSA ratio at the 25% cut-off and its ability to distinguish between prostate cancer and benign prostatic lesions.
Methods: This was a retrospective study conducted on male patients with total prostate-specific antigen values 10 ng/ml and with prostate histology results. Male patients with total prostate-specific antigen between 4 and 10 ng/ml had their free prostate-specific antigen determined together with the calculation of the free prostate-specific antigen ratio. The ratio was then correlated with prostate histology results to determine the presence of prostate cancer at the cut-off ratio of 25%.
Results: Prostate cancer was detected in 28 (21.37%) patients out of the total population of 131. Ninety-two patients had a FPSA ratio of 25%, 22 (22.8%) of whom were found to have prostate cancer. Notably the sensitivity and specificity were found to be 86% and 27% respectively, with a positive predictive of value of 21% at this cut-off.
Conclusions: The study demonstrates a %FPSA ratio of 25% not to be a good discriminator between prostatic cancerous and benign lesions. It is thus recommended that a prostate biopsy should be done based on clinical examination findings rather than the level of total prostate specific antigen from 0–10 ng/ml or %FPSA ratio. |
| format | Article |
| id | doaj-art-3423e8cb169446b1a2ab1e7cf4a58e99 |
| institution | Kabale University |
| issn | 2078-6190 2078-6204 |
| language | English |
| publishDate | 2018-08-01 |
| publisher | AOSIS |
| record_format | Article |
| series | South African Family Practice |
| spelling | doaj-art-3423e8cb169446b1a2ab1e7cf4a58e992025-08-20T03:47:09ZengAOSISSouth African Family Practice2078-61902078-62042018-08-0160410.4102/safp.v60i4.48893866Performance of free prostate-specific antigen ratio in differentiating between prostatic cancer and benign prostatic lesions at a referral hospital in South AfricaBoitumelo Phiri-Ramongane0Ayeaye Khine1Sefako Makgatho Health Science University; National Health Laboratory Services; Dr George Mukhari Academic Hospital, MedunsaSefako Makgatho Health Science University; National Health Laboratory Services; Dr George Mukhari Academic Hospital, MedunsaBackground: Prostate cancer is a leading cause of morbidity and mortality in our male population, thus screening initiatives will help to improve outcomes. The current screening marker, total prostate-specific antigen (PSA), is not prostate cancer specific. The development of percentage free PSA (%FPSA) has largely improved the detection of prostate cancer. Objectives: To assess the performance of %FPSA ratio at the 25% cut-off and its ability to distinguish between prostate cancer and benign prostatic lesions. Methods: This was a retrospective study conducted on male patients with total prostate-specific antigen values 10 ng/ml and with prostate histology results. Male patients with total prostate-specific antigen between 4 and 10 ng/ml had their free prostate-specific antigen determined together with the calculation of the free prostate-specific antigen ratio. The ratio was then correlated with prostate histology results to determine the presence of prostate cancer at the cut-off ratio of 25%. Results: Prostate cancer was detected in 28 (21.37%) patients out of the total population of 131. Ninety-two patients had a FPSA ratio of 25%, 22 (22.8%) of whom were found to have prostate cancer. Notably the sensitivity and specificity were found to be 86% and 27% respectively, with a positive predictive of value of 21% at this cut-off. Conclusions: The study demonstrates a %FPSA ratio of 25% not to be a good discriminator between prostatic cancerous and benign lesions. It is thus recommended that a prostate biopsy should be done based on clinical examination findings rather than the level of total prostate specific antigen from 0–10 ng/ml or %FPSA ratio.https://safpj.co.za/index.php/safpj/article/view/4889diagnostic accuracynon-communicable diseasesprostatic neoplasmscreening |
| spellingShingle | Boitumelo Phiri-Ramongane Ayeaye Khine Performance of free prostate-specific antigen ratio in differentiating between prostatic cancer and benign prostatic lesions at a referral hospital in South Africa South African Family Practice diagnostic accuracy non-communicable diseases prostatic neoplasm screening |
| title | Performance of free prostate-specific antigen ratio in differentiating between prostatic cancer and benign prostatic lesions at a referral hospital in South Africa |
| title_full | Performance of free prostate-specific antigen ratio in differentiating between prostatic cancer and benign prostatic lesions at a referral hospital in South Africa |
| title_fullStr | Performance of free prostate-specific antigen ratio in differentiating between prostatic cancer and benign prostatic lesions at a referral hospital in South Africa |
| title_full_unstemmed | Performance of free prostate-specific antigen ratio in differentiating between prostatic cancer and benign prostatic lesions at a referral hospital in South Africa |
| title_short | Performance of free prostate-specific antigen ratio in differentiating between prostatic cancer and benign prostatic lesions at a referral hospital in South Africa |
| title_sort | performance of free prostate specific antigen ratio in differentiating between prostatic cancer and benign prostatic lesions at a referral hospital in south africa |
| topic | diagnostic accuracy non-communicable diseases prostatic neoplasm screening |
| url | https://safpj.co.za/index.php/safpj/article/view/4889 |
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