Free-to-total prostate specific antigen ratio in clinical staging of prostate cancer

Hiroshi Maeda, Yoichi Arai, Satoshi Ishitoya, Kazutoshi Okubo, Yoshitaka Aoki, Takashi Okada, Shinya Maekawa

Research output: Contribution to journalArticlepeer-review

4 Citations (Scopus)


The value of the free-to-total serum prostate-specific antigen (f/t PSA) ratio was compared with that of the total prostate specific antigen (tPSA) value for the prediction of clinical stage in patients with prostate cancer. The f/t PSA ratio was obtained from the frozen sera of 56 untreated patients with histologically proven BPH and 78 patients with prostate cancer. The clinical stage was organconfined in 36, locally advanced in 20 and metastatic in 22 patients. Serum levels of free PSA (fPSA) and tPSA were determined using a chemiluminescent enzyme immunoassay. The f/t PSA ratio was calculated by dividing the fPSA value by the tPSA value and was compared with tPSA and fPSA in the correlation with clinical stage via the Spearman rank correlation test. Patients with prostate cancer had a significantly lower f/t PSA ratio than patients with BPH. The f/t PSA ratio did not differ between patients with clinically localized and metastatic cancer. tPSA and fPSA reflected the clinical stage and the extent of bone metastasis more accurately than the f/t PSA ratio. The extent of bone metastasis had no effect on the f/t PSA ratio. The f/t PSA ratio had no additional value in clinical staging compared to tPSA. Our study suggests that the f/t PSA ratio does not reflect tumor load.

Original languageEnglish
Pages (from-to)307-311
Number of pages5
JournalActa Urologica Japonica
Issue number5
Publication statusPublished - 1998 May
Externally publishedYes


  • Benign prostatic hyperplasia
  • Free/total
  • Prostate cancer
  • Prostate specific antigen

ASJC Scopus subject areas

  • Medicine(all)


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