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Aims of the study: Retrospective studies investigating the use of percent free free-PSA for early detection of prostate cancer were limited for various reasons: by their use of long-term stored sera, poor mix of non-cancer to cancer cases and the use of only men with PSA values between 4.0 and 10.0 ngamL. This prospective study investigates the clinical utility of percent free-PSA and complexed-PSA for early detection of prostate cancer in 219 consecutive men presenting for prostate biopsy. Methods: Of 246 consecutive men who underwent ultrasound guided sextant biopsy of the prostate for PSA elevation andaor suspicious digital rectal exam, 219 men had serum total PSA levels between 2.0 and 20.0 ngamL and were included in this study. Serum total, free and complexed (PSA±ACT) were measured (Hybritech Inc.). Results: Pathologic examinations demonstrated that 72% and 28% of the biopsies were non-cancer and cancer respectively. The mean percent free-PSA was statistically different between the groups (cancer 14% AE 6.4 and non-cancer 18 AE 9%, P`0.001) and improved cancer detection. PSA±ACT provided only modest improvement in cancer detection over that of total PSA. Among this cohort of men, the optimal total PSA re¯ex range for percent free-PSA was 3.0 ± 7.0 ngamL (38% speci®city) with a percent free free-PSA cut-off of 20% (95% sensitivity) yet only affected 56% of the cases. Conclusions: PSA±ACT added very little additional value to the clinical utility of total PSA for early detection. Percent free free-PSA performed well for all re¯ex ranges. A sensitivity and speci®city of 95% and 20% respectively were obtained using a single cut-off of 25% for percent free-PSA for the group of men with total PSA values between 4.0 and 10.0 and correlated well with recently reported prospective analyses.

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BACKGROUND:Reference intervals of high-sensitivity troponin T (hs-cTnT) and N-terminal pro-B-type natriuretic peptide (NT-proBNP) have been determined from Western populations. No data are available regarding expected values in Asian populations.

There does not appear to be any reason to differentiate between AMCB and MBC given the similarities in presentation, treatment and prognosis. J. Surg. Oncol. 2016;114:533-536. © 2016 Wiley Periodicals, Inc.