Evaluation of the serum testosterone to prostate‐specific antigen ratio as a predictor of prostate cancer risk |
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Authors: | Juan Morote Jacques Planas Cristobal Ramirez Esther Gómez Carles X Raventós José Placer Roberto Catalán Inés M De Torres |
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Institution: | 1. Departments of Urology, Biochemistry and;2. Pathology, Vall d’Hebron Hospital, Autónoma University of Barcelona, Spain |
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Abstract: | Study Type – Diagnostic (exploratory cohort) Level of Evidence 2b OBJECTIVE To analyse the ratio of serum testosterone (sT) to prostate‐specific antigen (PSA) as a predictor of prostate cancer risk, as low levels of sT have been related to a greater risk of prostate cancer, and its ratio with serum PSA level was recently proposed as a new tool to increase the specificity of PSA. PATIENTS AND METHODS In all, 439 consecutive men with a normal digital rectal examination and a serum PSA level of 4.1–20 ng/mL had a transrectal ultrasonography‐guided biopsy using a 10‐core scheme, with an additional 1–8 cores according to prostate volume and patient age. The sT level was determined before the procedure using a chemiluminescent assay, and the ratio of sT to PSA (sT/PSA) was calculated after transforming sT measurements from ng/dL to ng/mL. The percentage free PSA (%fPSA) and PSA density were also included in this analysis. RESULTS The overall cancer detection rate was 42.1%. The median sT level was 469 ng/dL in men with cancer and 499 ng/dL in those without (P = 0.521). The median sT/PSA was 0.68 and 0.74, respectively (P = 0.215). However, the median %fPSA was 14 in men with cancer and 17 in men without (P < 0.001) and the median PSA density was 0.22 and 0.16, respectively (P < 0.001). The multivariate analysis confirmed the independent predictive value only for %fPSA (odds ratio 0.94, 95% confidence interval 0.91–0.98) and PSA density (5.8, 3.42–19.8). CONCLUSION These results do not support the use of sT/PSA for predicting the risk of prostate cancer and to increase the specificity of PSA. |
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Keywords: | prostate cancer serum testosterone PSA ratio prediction |
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