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Anales de la Facultad de Medicina

Print version ISSN 1025-5583


ORTIZ, José  and  ALMOGUER, Emilio. Efficiency of free PSA index in prostate gland cancer diagnosis. An. Fac. med. [online]. 2015, vol.76, n.1, pp.27-32. ISSN 1025-5583.

Objectives: To determine the efficiency of PSA free index in prostate gland cancer diagnosis. Design: Retrospective study. Setting: Hospital Nacional Edgardo Rebagliati Martins, EsSalud, Lima, Peru. Participants: Patients undergoing prostate biopsy. Interventions: Data was collected from hospital medical records and pathology reports of 371 patients undergoing prostate biopsy, 104 with prostate cancer diagnosis and 267 with benign prostatic hyperplasia. Main outcome measures: Sensitivity, specificity, positive predictive value, negative predictive value, ROC (receiver operating characteristic) curve and area under the ROC curve (AUC). Results: Free PSA cutoff level of 0.20 used in clinical practice showed sensitivity of 0.85, specificity 0.51, positive predictive value 0.41, and negative predictive value 0.90. Sensitivity of 0.95 was obtained with cutoff at 0.28. The area under the ROC curve was 0.78. Conclusions: Free PSA index test showed better specificity than total PSA and would avoid unnecessary biopsies. However it would be advisable to raise the 0.20 cutoff in order to increase the test sensitivity to 95% so as to prevent loss of prostate cancer detection.

Keywords : Prostate specific antigen; free PSA index; prostate cancer.

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