F. Espana et al., LONGITUDINAL EVALUATION OF THE COMPLEXED-TO-TOTAL PROSTATE-SPECIFIC ANTIGEN RATIO IN MEN WITH PROSTATE DISEASE - EFFECT OF TREATMENT, European journal of cancer, 34(9), 1998, pp. 1375-1380
The longitudinal changes in the complexed-to-total prostate specific a
ntigen (PSA) ratio were evaluated in 90 men with benign prostatic hype
rplasia (BPH) and 50 men with prostate cancer. The influence of treatm
ent on this ratio was studied in 45 BPH patients and 50 patients with
prostate cancer. Using a cut-off of 0.80 for the complexed-to-total PS
A ratio, the large majority of prostate cancer patients had a ratio ab
ove the cut-off before treatment in serial determinations, whereas mos
t BPH patients had a ratio consistently below that value. However, the
few prostate cancer patients who had a ratio less than or equal to 0.
80 showed this low ratio in serial determinations, as did BPH patients
who had a ratio greater than or equal to 0.80. During treatment, the
ratio significantly decreased in 43 of the 50 patients with prostate c
ancer in parallel with the decrease in total PSA, and 34 of the 41 pat
ients that had a pretreatment ratio > 0.80 showed a ratio less than or
equal to 0.80 during hormonal therapy. Our results show that neither
the physiological changes in total and complexed PSA nor the treatment
of BPH patients change the diagnostic efficacy of the complexed-to-to
tal PSA ratio, whereas in prostate cancer patients under hormonal ther
apy, the ratio decreased in parallel with the decrease in total PSA. T
his suggests that, apart from improving the diagnostic efficacy of tot
al PSA, the complexed-to-total PSA ratio could also be used to monitor
BPH patients for newly developed tumours or to monitor therapy in pat
ients with prostate cancer. (C) 1998 Elsevier Science Ltd. All rights
reserved.