Results: The mean age of the entire population was 63.6 years (range 35 to 86). Abnormal digital rectal examination findings were present in 33.4% of the patients. The mean and median values of PSA and cPSA were significantly higher and the F/T PSA ratio was lower in patients with prostate cancer.

This finding has been exploited in the use of the ratio of free to total PSA and complexed PSA (cPSA) as a means of distinguishing between prostate cancer and BPH as a cause of an elevated PSA. (See 'Serum free and bound PSA' below and 'Complexed PSA' below.)

The total, free and complexed PSAs increased with age (linear trend, p < 0.001), but the percent free and complexed PSA and the free/complexed PSA did not change significantly with age. Total PSA GM increased from 0.74 μg/l, for men 40-49 years, to 1.82 μg/l for men 80 years and older.

Over the past years, the assessment of equimolarity has been typically performed by the characterization of the recovery of IS 96/670, consisting of 90% PSA-ACT and 10% PSA free form, by marketed PSA assays.

Correlation between the complex PSA/total PSA ratio and the free PSA/total PSA ratio, sensitivity and specificity of both markers for the diagnosis of prostate cancer Correlación del cociente PSA complex/PSA total con el cociente PSA libre/PSA total, sensibilidad y especificidad de ambos marcadores para el diagnóstico del cáncer de prostata☆

PSA, a protein produced by prostate gland cells, circulates through the body in two ways: either bound to other proteins or on its own. PSA traveling alone is called free PSA. The free-PSA test measures the percentage of unbound PSA; the PSA test measures the total of both free and bound PSA.

Prostate specific antigen (PSA) exists in the serum in several molecular forms that can be measured by immunodetectable assays: free PSA, PSA complexed to alpha 1-antichymotrypsin (complexed PSA) and total PSA, which represents the sum of the free and complexed forms.

The ease of calibration and the accuracy of free PSA assays in comparison with assays of the PSA-ACT complex suggest that measurements of free to total PSA most accurately reflect the inverse of the proportion of PSA complexed to ACT in serum. The most promising approach to improve the specificity of PSA, particularly in the range lower 10 ng/ml, is the measurement of molecular isoforms of PSA. These are the disengaged free PSA (fPSA) and the complexed PSA (cPSA) bound to α1-antichymotrypsin. Introduction: Prostatic tumor tissue produces a more complex form of PSA (cPSA) than free PSA (fPSA). For the early detection of prostate cancer, cPSA is supposed to be more sensitive than the ratio of fPSA and tPSA. The aim of the study was to evaluate the diagnostic value of cPSA in the early detection of malignant prostatic tumor.

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Complexed PSA alone did not enhance the overall diagnostic accuracy compared with percent free PSA in the Hybritech total PSA range between 4.01 and 6.00 ng./ml., between 6.01 and 10.00 ng./ml., and between 2.50 and 6.00 ng./ml. ^{Complexed PSA test measures both PSA that is floating freely in the blood and PSA that is attached to other proteins in the blood. PSA levels rise with age, and men of different ethnicities may have naturally higher PSA levels, so discuss with your doctor what a healthy PSA level looks like for you.}

Circulating PSA can be divided into two main forms: complexed and free. Most circulating PSA is bound to a variety of protease inhi- bitors, most commonly a-1-antichymotrypsin, and the proportion of the total PSA concentration which is free or unbound is relatively small.

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