The Role of Complex PSA in the Prediction of Prostatic Cancer

Aim of Work: Is to improve diagnostic accuracy of cancer prostate by studying CPSA and other routine diagnostic parameters to obtain a predictive index useful in the postscreening clinical practice. Subject and Methods: The study included 41 individuals, 26 patients and 15 normal controls matching age and sex. They were divided based on TPSA concentration in serum into: 15 control with TPSA 4.00ng/ml with mean±S.E. 2.28± 0.28, 26 patients with TPSA 4.00ng/ml who were divided into two groups: Group 1: 11 patients with TPSA range 4.0- 10.0ng/ml with mean±S.E. 6.37±0.66 and Group 2: 15 patients with TPSA 10.0ng/ml with mean±S.E. 19.38±1.58. Labora-tory investigations included the determination of TPSA, FPSA, CPSA, serum Glucose, liver and kidney function tests, serum urea and lipids profile. Results: Age, weight and BMI were higher in patients than controls. The fasting blood glucose, urea, creatinine, cholesterol, LDL-C and T.G level were significantly higher compared to control group. The levels of TPSA, FPSA and CPSA in group 1 and 2 were significantly higher compared to control group (p 0.05). While the % FPSA level in group 1 and 2 was significantly lower compared to control group (p 0.05). There was a powerful statistically significant correlation between TPSA, FPSA and CPSA. While there was a negative correlation between TPSA and % FPSA Ratio. Conclusion: The CPSA should be used as a surrogate marker to increase the detection rate of cancer prostate and to reduce unnecessary biopsies as it is an economic test with less chance of errors in diagnosis. Further studies on wide scales are needed to detect if the specificity and sensitivity of CPSA are better than % FPSA in the diagnosis of PCa.