Ⅳ型前列腺炎炎症分级和范围与前列腺特异性抗原之间的关系

目的:探讨Ⅳ型前列腺炎炎症组织病理学分级和范围与前列腺特异性抗原(PSA)的关系。方法:对120例临床可疑前列腺癌患者采用B超引导下经会阴前列腺穿刺病理活检,排除前列腺癌及不合并炎症的前列腺增生病例,仅BPH合并前列腺炎病例入选,采用NIH-Ⅳ型前列腺炎组织病理学分类方法对每例患者标本按炎症位置、范围和分级3方面分3级比较,评价炎症与血清PSA的关系。结果:120例患者中BPH合并前列腺炎症46例。①组织病理学炎症范围分级,1级35例,2级7例,3级4例,tPSA分别为(8.46±4.09)μg/L、(15.26±5.26)μg/L和(21.05±7.58)μg/L,fPSA分别为(1.75±0.93)μg/L、(2.54±0.72)μg/L和(3.19±1.13)μg/L,PSAD分别为0.15±0.11、0.26±0.07和0.42±0.19。三级之间比较tPSA(P=0.001)、fPSA(P=0.008)和PSAD(P<0.001)差异均具有显著性。②组织病理学炎症分级,1级32例,2级10例,3级4例。tPSA分别为(8.37±4.07)μg/L、(13.30±5.69)μg/L和(21.05±7.58)μg/L。fPSA分别为(1.76±0.93)μg/L、(3.27±2.21)μg/L和(3.19±1.13)μg/L。PSAD分别为0.14±0.11、0.25±0.06和0.42±0.19。三级之间比较tPSA(P=0.002)、fPSA(P=0.024)和PSAD(P<0.001)差异均有显著性。③组织病理学炎症位置分级,1级19例,2级17例,3级10例,三级之间tPSA、fPSA、%fPSA差异均无显著性(P>0.05)。④组织病理学炎症范围与tPSA(r=0.6,P<0.001)、fPSA(r=0.5,P=0.001)和PSAD(r=0.6,P<0.001)呈显著正相关关系。组织病理学炎症分级与tPSA(r=0.5,P<0.001)、fPSA(r=0.4,P=0.008)和PSAD(r=0.7,P<0.001)呈显著正相关关系,与%fPSA呈显著负相关关系(r=-0.4,P=0.013)。结论:无症状前列腺炎症患者组织病理学炎症的分级和范围与血PSA显著相关,病理医生应对前列腺穿刺标本进行炎症描述,其对高分级前列腺炎症患者可避免反复活检。     

有症状性和无症状性前列腺炎对血清tPSA及fPSA影响的比较

目的:探讨有症状性和无症状性前列腺炎患者的血清总前列腺特异抗原(tPSA)、游离型PSA(fP SA)以及fPSA/tPSA间是否存在差异。方法:对比分析53例有临床症状、41例无临床症状的前列腺炎患者及22例非前列腺炎患者的血清tPSA、fPSA浓度以及fPSA/tPSA比值间的差异,并对比39例有症状性前列腺炎患者治疗前后tPSA、fPSA以及fPSA/tPSA比值的变化。结果:有症状性及无症状性前列腺炎患者间tPSA、fPSA以及fPSA/tPSA的差异均无统计学意义(P>0.05),但与对照组之间的差异均有统计学意义(P<0.01)。有症状患者治疗后tPSA、fPSA均比治疗前明显下降(P<0.01)。结论:有症状性和无症状性前列腺炎均可导致血清tPSA、fPSA升高,在以其作为前列腺癌诊断和筛选的指标时,应该考虑前列腺炎所造成的干扰;血清tPSA、fPSA可以作为前列腺炎诊断和疗效判断的一项辅助指标。     

良性前列腺增生病人血清不同类别PSA的检测与分析

目的 :分析前列腺增生 (BPH)病人血清中不同前列腺特异抗原 (PSA)的稳定性 ,探讨其在前列腺疾病诊断中的应用价值。　方法 :将病理诊断证实的 1 0 5例BPH病人按总PSA(tPSA)水平分为 3组 :A组 (tPSA <4μg/L)67例 ,B组 (tPSA值 4～ 1 0 μg/L) 2 6例 ,C组 (tPSA >1 0 μg/L) 1 2例。按年龄分为 3组 :a组 (≤ 55岁 ) 1 8例 ,b组 (56～ 69岁 ) 33例 ,c组 (≥ 70岁 ) 54例。采用Bayer磁微粒化学发光免疫方法 ,测定各组BPH病人血清中的复合PSA(cPSA)、tPSA、游离PSA(fPSA) ,并计算cPSA/tPSA、fPSA/tPSA、fPSA/cPSA比值 ,比较它们在不同年龄和tPSA水平组间的稳定性。　结果 :无论在不同的tPSA水平组 ,还是在不同的年龄组 ,cPSA/tPSA比值和fPSA/tPSA、fP SA/cPSA比值比其它各种PSA更稳定。　结论 :cPSA/tPSA比值和fPSA/tPSA、fPSA/cPSA比值在前列腺疾病的诊断中可能更具有应用价值     

上海闵行区PSA异常的老年男性前列腺疾病跟踪调查与分析

目的 :了解老年男性前列腺疾病的发病情况及前列腺特异抗原 (PSA)、游离PSA(fPSA)、fPSA与血清总PSA(tPSA)的比值 (f/t)跟年龄、前列腺体积 (PV)之间的关系。方法 :对 142 5名老年男性进行前列腺指检 (DRE)和PSA测定 ,然后对其中tPSA >4μg/L者进行了随访复查 ,检查项目包括DRE、tPSA、fPSA和经直肠前列腺B超 ,并建议行前列腺穿刺活检。结果 :142 5例调查者中 ,tPSA >4μg/L者 16 9例 (11.9%) ,其中 84例得到随访 ,发现tPSA、f/t与年龄无相关性 (P >0 .0 5 ) ,而PV与年龄呈正相关 (P <0 .0 5 )。 17例接受了前列腺穿刺活检 ,1例接受手术治疗 ,其中 9例被病理检查证实为前列腺增生 (BPH) ,9例被证实为前列腺癌 (PCa)。BPH组与PCa组tPSA差异有显著性意义 ,而两组PV差异无显著性意义。结论 :PSA是诊断前列腺癌的重要瘤标 ,前列腺“6点法”穿刺活检是诊断前列腺癌有效而必要的方法。     

单纯前列腺上皮内瘤回顾性分析(附142例病例分析)

目的通过对前列腺上皮内瘤(PIN)临床资料分析,探讨PIN的生物特性及应对策略。方法对31例无前列腺癌PIN(NPCaPIN)改变患者(其中1级23例,2、3级8例)的临床资料(包括患者血清PSA、fPSA/tPSA、PSA密度等区域计数资料以及穿刺标本免疫组织化学染色结果)进行回顾性分析,以同期确诊为前列腺癌(PCa)、良性前列腺增生(BPH)患者资料作为对照,分析低级别PIN(LGPIN)和高级别PIN(HGPIN)改变之间及NPCaPIN临床特征与PCa、BPH患者临床特征的差异。结果LGPIN和HGPIN改变的患者之间血清PSA水平和年龄存在差异(P<0.05);LGPIN和PCa患者之间血清PSA水平、前列腺体积、fPSA存在显著差异(P<0.01),PSA密度、fPSA/tPSA比值存在差异(P<0.05),和BPH患者之间各项均无明显差异;HGPIN改变和PCa患者之间前列腺体积、fPSA水平和年龄存在差异(P<0.05),和BPH患者之间血清PSA水平差异显著(P<0.01),fPSA/tPSA比值和年龄(P<0.05)存在差异;NPCaPIN和PCa患者之间血清前列腺体积、fPSA水平和年龄、血清PSA水平、PSA密度存在显著差异(P<0.01),和BPH患者之间fPSA/tPSA比值(P<0.05)存在差异。P63、AE1、AE3、P504S、PSA免疫组织化学结果NPCaPIN组类似于BPH而完全异于PCa。结论LGPIN的临床和病理特征与BPH相似,而HGPIN的临床和病理方面具有一定的前列腺恶性肿瘤特征,需要积极的临床追踪观察。     

无症状性炎性前列腺炎对血清PSA、fPSA的影响

目的　探讨无症状性炎性前列腺炎(NIH分类Ⅳ型)对血清PSA、fPSA的影响。方法　对比分析36例NIH分类Ⅳ型、42 例有症状性慢性前列腺炎(NIH分类ⅢA型)患者以及22例健康对照组的血清PSA、fPSA、fPSA/tPSA之间的差异。结果　血 清PSA、fPSA、fPSA/tPSA在Ⅳ型和ⅢA型前列腺炎患者间差异无显著性(P>0.05),但与正常对照组比较差异有显著性(P< 0.01)。结论　NIH分类Ⅳ型前列腺炎可引起血清PSA、fPSA升高。对无症状、高血清PSA患者行前列腺活检前,应考虑到患 Ⅳ型前列腺炎的可能。     

高龄危重患者良性前列腺增生氩氦刀冷冻治疗研究(附21例报告)

目的:评价高龄危重患者BPH经皮冷冻的临床疗效。方法:使用ENDCARE冷冻手术系统,对72～91岁,同时伴有明显心肺功能障碍的21例BPH患者实施B超引导下的氩氦刀冷冻治疗,观察术后前列腺活检、前列腺超声图像、尿流率、血清PSA等变化。结果:术后前列腺组织出现变性、坏死,表现为完全消融现象;氩氦刀治疗前后平均尿流率分别为(3.8±2.1)、(17.0±5.8)ml/s(P<0.01);术前血清PSA(3.7±2.4)μg/L,术后1周(22.6±13.1)μg/L,与术前相比明显增高(P<0.01),术后4周(1.7±1.4)μg/L,与术前相比明显降低(P<0.05)。结论:经皮氩氦刀冷冻治疗BPH近期疗效满意,是高龄危重患者较好的治疗方法。     

前列腺特异抗原对前列腺癌诊断和疗效监测的价值探讨

目的 探讨前列腺特异抗原(tPSA)、游离PSA(fPSA)以及fPSA/tPSA在前列腺癌(PCa)诊断和疗效监测中的临床价值。方法 采用全自动化学发光免疫分析仪测定36例正常人、42例前列腺增生(BPH)和44例前列腺癌患者tPSA、fPSA,并计算fPSA/tPSA比值。同时,对29例前列腺癌患者术后tPSA、fPSA进行动态监测。结果 fPSA/tPSA对PCa诊断的特异性为88.1％,诊断指数为0.79,显著高于单独tPSA(P<0.05)。结论 fPSA/tPSA的引入提高了对PCa诊断的特异性,动态监测是提示肿瘤是否转移与复发最理想的指标。     

ROC曲线分析比较tPSA、fPSA／tPSA和PSAD在PSA灰区前列腺癌诊断中的价值

目的 ROC曲线分析探讨前列腺特异性抗原密度(PSAD)、总PSA(tPSA)和游离PSA/总PSA(fPSA/tPSA)3者在PSA灰区前列腺癌(PCa)中的临床诊断价值.方法 同顾性分析tPSA在4～10ng/ml之间的前列腺增生(BPH)患者75例和前列腺癌患者31例.化学发光法测定血清tPSA和fPSA,经直肠超声(TRUS)测定前列腺体积,计算fPSA/tPSA和PSAD.比较BPH组和PCa组间tPSA、PSAD和fPSA/tPSA各指标的差异,分析各指标在ROC曲线卜的面积、各指标的诊断特异性及敏感性.结果 PCa组与BPH组tPSA差异无统计学意义(P＞0.05),PCa组fPSA/tPSA比值较BPH组降低(P＜0.01),PSAD值较BPH组升高(P＜0.05).ROC曲线下的面积从大到小为fPSA/tPSA＞PSAD＞tPSA.在诊断敏感性相同的情况下,fPSA/tPSA比值诊断特异性高于PSAD的诊断特异性.当fPSA/tPSA临界值取0.16时,诊断前列腺癌的灵敏度和特异性为67.7%和79.7%,PSAD临界值取0.12时,其灵敏度和特异性为61.3%和62.7%.结论 当tPSA在诊断灰区时,PSAD和fPSA/tPSA可以提高前列腺癌的诊断特异性和敏感性,fPSA/tPSA较PSAD有更高的诊断价值.     

BPH患者组织学前列腺炎与PSA、前列腺体积、PSAD、IPSS、Qmax及PVR的相关性研究

目的:探讨BPH患者组织学前列腺炎与PSA、前列腺体积、PSA密度(PSAD)、IPSS、最大尿流率(Qmax)及残余尿量(PVR)的相关性。方法:手术切除或经尿道前列腺电切术(TURP)治疗的BPH患者673例。按照是否伴有组织学前列腺炎将患者分为两组:A组:BPH伴组织学前列腺炎;B组:BPH不伴有组织学前列腺炎。比较两组患者PSA、前列腺体积、PSAD、IPSS、Qmax及PVR。结果:A组PSA水平为(5.64±2.48)μg/L,前列腺体积(43.66±13.11)ml,PSAD 0.129±0.048,IPSS(24.72±5.39)分,Qmax(6.94±3.23)ml/s,PVR(124.90±49.80)ml;B组PSA水平为(4.97±1.99)μg/L,前列腺体积(40.41±11.44)ml,PSAD 0.123±0.034,IPSS(23.40±6.21)分,Qmax(7.75±3.52)ml/s,PVR(112.73±50.03)ml。A组PSA水平、前列腺体积、IPSS和PVR均明显高于B组(P<0.05);A组Qmax明显低于B组(P<0.05);PSAD两组间差异无统计学意义(P>0.05)。结论:组织学前列腺炎能明显增加患者的PSA水平、前列腺体积、IPSS和PVR,降低患者Qmax。但是组织学前列腺炎与PSAD无关;组织学前列腺炎是影响BPH临床进展的重要因素。     

A multicenter clinical trial on the use of alpha1-antichymotrypsin-prostate-specific antigen in prostate cancer diagnosis

BACKGROUND: The aim was to evaluate the clinical performance of alpha(1)-antichymotrypsin prostate-specific antigen (PSA-ACT) for early diagnosis of prostate cancer (PCa) in a multicenter trial. METHODS: Three hundred sixty-seven white men with PCa and 290 with benign prostatic hyperplasia (BPH) with tPSA concentrations between 2 and 20 microg/L were analyzed. The Elecsys system 2010 (Roche Diagnostics, Germany) was used for determination of total PSA (tPSA) and free PSA (fPSA). The PSA-ACT test was a prototype assay used on the ES system (Roche Diagnostics). RESULTS: The median concentrations of tPSA (PCa: 8.43 microg/L vs. BPH: 6.60 microg/L) and PSA-ACT (8.30 microg/L vs. 6.46 microg/L) were significantly different, respectively. The median ratios of fPSA/tPSA (PCa: 12% vs. BPH: 16%) and PSA-ACT/tPSA (98% vs. 95%) were significantly different. Receiver operating characteristics (ROC) analysis for discrimination between PCa and BPH (tPSA between 2 and 20 microg/L) was performed with 252 matched pairs and showed that the area under the curve (AUC) of the ratio fPSA/tPSA (0.66) was significantly different from tPSA (0.50) and PSA-ACT (0.52). PSA-ACT alone or the ratio PSA-ACT/tPSA (0.56) were not significantly different from tPSA. For tPSA between 4 and 10 microg/L (n = 145 pairs), the AUC of the ratio fPSA/tPSA (0.65) was significantly higher than tPSA (0.50) and PSA-ACT (0.54). Significant differences between tPSA and PSA-ACT or PSA-ACT/tPSA (0.56) were not found. CONCLUSIONS: The determination of PSA-ACT as well as the PSA-ACT/tPSA ratio did not improve the diagnostic impact in patients undergoing evaluation for PCa compared to fPSA/tPSA ratio.     

Diagnostic validity of macrophage migration inhibitory factor in serum of patients with prostate cancer: a re-evaluation

BACKGROUND: Recent studies suggest that macrophage migration inhibitory factor (MIF) in serum is of prognostic significance for prostate cancer. The aim of this study was to re-evaluate this hypothesis. METHODS: Serum MIF levels were measured in healthy men (n = 86), untreated patients with benign prostate hyperplasia (BPH; n = 50), prostate cancer (PCa; n = 163), and after radical prostatectomy for 3 days (n = 5). PCa patients were classified according to the TNM system and the WHO grading scale. Prostate specific antigen (PSA) and C-reactive protein (CRP) were additionally determined. RESULTS: The MIF concentrations of healthy men and BPH patients did not differ (mean +/- SD, 2.08 +/- 1.08 microg/L vs. 2.04 +/- 1.08 microg/L), whereas the mean value of MIF in PCa patients was significantly decreased (1.77 +/- 1.12 microg/L). There was no any correlation between MIF and PSA (r(s) = -0.049, P = 0.271). MIF concentrations in patients with T1 tumors were higher than in those with T2 tumors (2.29 +/- 1.26 vs. 1.67 +/- 1.11 microg/L; P = 0.044). No any effect of grading was observed. After prostatectomy, the changes of PSA and MIF were not always concordant as MIF partly increased while PSA continuously decreased. Analyses of receiver-operating curves and logistic regressions did not show that MIF alone or MIF related variables (MIF/tPSA; fPSA/(tPSA x MIF); fPSA x MIF/tPSA) could improve specificity or sensitivity to detect prostate cancer in comparison to total PSA. CONCLUSION: Serum MIF alone or MIF to PSA related variables did not seem suitable for providing additional information on PCa patients. That re-evaluated diagnostic validity of MIF was in contrast to results by another group shown previously.     

Comparison of the clinical validity of free prostate-specific antigen, alpha-1 antichymotrypsin-bound prostate-specific antigen and complexed prostate-specific antigen in prostate cancer diagnosis

OBJECTIVE: To evaluate the diagnostic utility of free prostate specific antigen (fPSA), alpha-1- antichymotrypsin-bound PSA (PSA-ACT), complexed PSA (cPSA), and including their associated ratios to total PSA (tPSA) in serum for discrimination between prostate cancer (PCa) and benign prostatic hyperplasia (BPH). METHODS: A total of 166 white men (age: 65-88 years) with a tPSA between 2 and 20 microg/l were retrospectively analysed. Serum concentrations of tPSA, fPSA, PSA-ACT and cPSA were measured in 118 untreated PCa patients and 48 patients with BPH. The tPSA and cPSA concentrations were measured with the Bayer Immuno 1 system (Bayer Diagnostics, Tarrytown, USA). The Elecsys system 2010 (Roche Diagnostics, Mannheim, Germany) was used for determination of tPSA and fPSA. The PSA-ACT assay is a newly, developed prototype assay on the ES system (Roche Diagnostics, Mannheim, Germany). RESULTS: For statistical analysis only patients with tPSA between 2 and 20 microg/l were enrolled. The median concentrations of tPSA (Bayer: PCa 7.36 microg/l, BPH 4.03 microg/l; Roche: PCa 7.75, BPH 4.13), PSA-ACT (PCa 6.98, BPH 3.18) and cPSA (PCa 6.46, BPH 3.20) were significantly different. The median ratios of fPSA/tPSA (PCa 12.8 vs. BPH 22.4%), PSA-ACT/tPSA (PCa 89.8 vs. BPH 76.1%) and cPSA/tPSA (PCa 90.5 vs. BPH 81.7%) were significantly different between PCa and BPH patients. Using the areas under the curves, receiver operating characteristics analysis (tPSA: 2-20 microg/l) for discrimination between PCa and BPH showed that the ratios fPSA/tPSA (area under the curve: 0.77), PSA-ACT/tPSA (0.72) and cPSA/tPSA (0.78) were significantly different from tPSA (Bayer: 0.53; Roche: 0.55). PSA-ACT (0.64) and cPSA (0.59) alone were not significantly different from tPSA. The calculated ratios fPSA/tPSA, PSA-ACT/tPSA and cPSA/tPSA were not significantly different. CONCLUSION: The determination of PSA-ACT or cPSA and the associated ratios do not improve the diagnostic impact to discriminate between PCa and BPH compared to fPSA/tPSA ratio. The ratios PSA-ACT/tPSA or cPSA/tPSA can be considered to be alternative tools of fPSA/tPSA.     

血清前列腺特异性抗原预测中国男性前列腺增生患者前列腺体积的准确性研究

目的通过比较血清总前列腺特异性抗原（tPSA）、游离前列腺特异性抗原（fPSA）与年龄预测前列腺体积（PV）大小的准确性,寻找预测PV简便易行、较准确的预测因子。 方法收集2005年1月至2014年12月因下尿路症状到我院诊治下尿路症状/良性前列腺梗阻（LUTS/BPO）患者的年龄、PV及PSA检测值;采用SPSS 13.0软件处理数据,用皮尔森线性相关关系描述年龄、血清tPSA及血清fPSA与PV的相关性,并采用卡方检验及受试者特征曲线（ROC）分析比较血清tPSA、血清fPSA预测PV的准确性。 结果入选6 308例男性,皮尔森线性相关分析显示年龄-PV、tPSA-PV和fPSA-PV的相关系数分别是0.197、0.434、和0.446,其P值均<0.05,具有相关性;在tPSA为0~4 μg/L时,tPSA和fPSA预测PV在（30~50）ml、（50~70）ml和PV>70 ml组的AUC-ROC分别为（0.617、0.732、0.761）和（0.625、0.738、0.767）;在tPSA为0~4 μg/L时,tPSA和fPSA预测PV在（30~50）ml、（50~70）ml和PV>70 ml组的最佳临界值分别为tPSA（1.3 μg/L、1.6 μg/L、2.0 μg/L）和fPSA（0.3 μg/L、0.4 μg/L、0.5 μg/L）。 结论中国LUTS/BPO男性血清fPSA与PV正相关程度最高,血清tPSA与fPSA均可作为独立预测因子预测中国LUTS/BPO男性的PV,可作为临床上预测PV简便易行的指标,其中fPSA预测的准确性更高。     

fPSA/tPSA比值优化前列腺癌早期诊断作用的研究

目的 :探讨游离前列腺特异性抗原 /总前列腺特异性抗原 (fPSA/tPSA)比值在优化tPSA早期诊断前列腺癌(PCa)中的作用。　方法 :以长春市 5 0岁以上PCa集团普查中tPSA在 4 .0～ 2 0 .0 μg/L范围、并接受前列腺活检的1 87例受检者为研究对象 ,测定tPSA、fPSA含量 ,应用SPSS 1 0 .0软件对不同区间fPSA/tPSA比值进行统计学分析。结果 :①tPSA在 4 .0～ 1 0 .0 μg/L、1 0 .0～ 2 0 .0 μg/L区间时 ,PCa检出率分别为1 8.1 %、2 2 .5 %。②ROC曲线分析显示不同区间时fPSA/tPSA比值的曲线下面积 (AUC)均大于tPSA (P <0 .0 5 )。③fPSA/tPSA比值取 0 .2 5为界值时 ,tPSA在 4 .0～ 1 0 .0 μg/L、1 0 .0～ 2 0 .0 μg/L两区间诊断PCa的敏感度分别为90 .5 %和 87.5 % ,可以分别避免 2 6 .7%和 1 1 .3%的人群进行活检。　结论 :在集团普查中 ,fPSA/tPSA比值在tPSA为 4 .0～ 2 0 .0 μg/L时可以提高检测PCa的特异性 ,减少不必要的活检。     

fPSA/tPSA比值在前列腺癌和前列腺增生鉴别中的意义

目的 探讨fPSA/tPSA比值在前列腺癌和前列腺增生鉴别中的意义。方法 回顾分析了2000年9月-2001年8月期间在我院住院治疗的72例前列腺癌和前列腺增生患者的tPSA和fPSA/tPSA比值。结果 72例患者中,前列腺增生48例,前列腺癌24例。tPSA为4.0～10.0ng/ml之间时,前列腺癌患者3例,其fPSA/tPSA平均值为0.12,而前列腺增生患者有16例,其fPSA/tPSA平均值为0.21,两者差异明显。tPSA为4.0～10.0ng/ml,fPSA/tPSA比值为0.20,诊断前列腺癌的特异性为61％,而敏感性为100％。结论 当tP-SA为4.0～10.0ng/ml时,fPSA/tPSA比值作为一种参考标准可以用于临床筛选潜在的前列腺癌患者。     

Comparisons of the various combinations of free, complexed, and total prostate-specific antigen for the detection of prostate cancer

OBJECTIVES: We compared the ability of three prostate-specific antigen (PSA) ratios - free-to- total PSA ratio (fPSA/tPSA), free-to-complexed PSA ratio (fPSA/cPSA), and complexed-to-total PSA ratio (cPSA/tPSA) - to distinguish prostate cancer from benign prostatic hyperplasia (BPH). METHODS: We tested 258 consecutive patients who underwent transrectal ultrasound-guided prostate needle biopsy because of an abnormal digital rectal examination or a Tandem-R PSA of >4.1 ng/ml. Free PSA (fPSA) and total PSA (tPSA) were measured by Tandem-R assay. alpha(1)-Antichymotrypsin-complexed PSA (cPSA) was measured by Markit-M PSA-ACT assay. RESULTS: Of the 258 patients, 204 had BPH, and 54 had prostate cancer. The specificity at 96% sensitivity for fPSA/tPSA, fPSA/cPSA, and cPSA/tPSA was 23, 25, and 33%, respectively. Of 162 patients with tPSA between 4.1 and 10.0 ng/ml, 132 had BPH and 30 had prostate cancer. The specificity at 96% sensitivity for f/tPSA, f/cPSA and c/tPSA was 32, 44, and 41%, respectively. There was no significant difference in the area under the receiver-operating characteristic curves among fPSA/tPSA, fPSA/cPSA, and cPSA/tPSA in the overall PSA range or in tPSA between 4.1 and 10.0 ng/ml. CONCLUSION: fPSA/tPSA, fPSA/cPSA, and cPSA/tPSA did not differ in their ability to distinguish prostate cancer from BPH.