The total, free and complexed PSAs increased with age (linear trend, p < 0.001), but the percent free and complexed PSA and the free/complexed PSA did not change significantly with age. Total PSA GM increased from 0.74 μg/l, for men 40-49 years, to 1.82 μg/l for men 80 years and older.
Results: The mean age of the entire population was 63.6 years (range 35 to 86). Abnormal digital rectal examination findings were present in 33.4% of the patients. The mean and median values of PSA and cPSA were significantly higher and the F/T PSA ratio was lower in patients with prostate cancer.
The ease of calibration and the accuracy of free PSA assays in comparison with assays of the PSA-ACT complex suggest that measurements of free to total PSA most accurately reflect the inverse of the proportion of PSA complexed to ACT in serum.
Complexed PSA test measures both PSA that is floating freely in the blood and PSA that is attached to other proteins in the blood. PSA levels rise with age, and men of different ethnicities may have naturally higher PSA levels, so discuss with your doctor what a healthy PSA level looks like for you.
Comparison of the clinical value of complexed PSA and total PSA in the discrimination between benign prostatic hyperplasia and prostate cancer Authors Michael Froehner 1 , Oliver W Hakenberg , Rainer Koch , Uta Schmidt , Axel Meye , Manfred P Wirth Affiliation
Many studies have explored the effect of free/total prostate-specific antigen (f/t PSA) ratio in monitoring prostate cancer. We conducted a meta-analysis to identify the accuracy of the f/t PSA ratio in the diagnosis of prostate cancer in patients who have PSA levels of 4 to 10 ng/mL.
These molecular differences explain the possibility to distinguish free from total PSA (F/T ratio). Free and complexed PSA have different clearances and significant differences between clearance of free PSA after radical prostatectomy (RP) and after open surgery for benign prostatic hyperplasia (BPH) are observed.
Introduction: Prostatic tumor tissue produces a more complex form of PSA (cPSA) than free PSA (fPSA). For the early detection of prostate cancer, cPSA is supposed to be more sensitive than the ratio of fPSA and tPSA. The aim of the study was to evaluate the diagnostic value of cPSA in the early detection of malignant prostatic tumor.
Complexed PSA alone did not enhance the overall diagnostic accuracy compared with percent free PSA in the Hybritech total PSA range between 4.01 and 6.00 ng./ml., between 6.01 and 10.00 ng./ml., and between 2.50 and 6.00 ng./ml.
The most promising approach to improve the specificity of PSA, particularly in the range lower 10 ng/ml, is the measurement of molecular isoforms of PSA. These are the disengaged free PSA (fPSA) and the complexed PSA (cPSA) bound to α1-antichymotrypsin.
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