FREE PSA

Description

  • < 0.05 – 0.42 ng/ml

Clinical significance

  • PSA is a glycoprotein related to the proteases enzyme family. PSA has been found to form complexes with two of the major extracellular protease inhibitors in blood, alpha anti chymotrypsin (ACT) and alpha macroglobulin (AMG). 
  • A small fraction of PSA remains free in blood. In prostate cancer patients PSA complexed with ACT (PSA-ACT typically the major form in circulation for about 50% of these patients) accounts for 85% of the total PSA present. So 12-15% of prostate cancer patients on the other hand present with free (that is, uncomplexed PSA as the predominant form
  • Free PSA is found to comprise significantly (p<0.0001) smaller fraction in patients with untreated prostate cancer than in patients with benign prostatic hypertrophy (BPH).
  • In many men with serum PSA levels less than 10 ng /ml, comparing total PSA levels to free PSA fractions has been proposed a way to facilitate discrimination between prostate cancer and BPH.
  • The ratio, Free PSA/ Total PSA has been found to be a superior diagnostic indicator than total PSA.

When to get tested

Elevated level

  • Benign prostate cells

Decreased level

Profile

Cancer

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