Prognostic Significance of Free Psa/ Total Psa Ratio In Predicting Bone Metastases In Patients With Prostate Cancer

Abstract Background In this study, we aimed to investigate the prognostic value of free prostate specific antigen/total prostate specific antigen (free PSA/ total PSA) ratio in prediciton of bone metastases in patient with prostate cancer. Methods In total 175 patients with prostate cancer who underwent whole-body bone scintigraphy were included in the study. All selected scintigraphic studies were reprocessed. Free PSA/total PSA ratio, alkaline phosphatase(ALP) values and Gleason scores of patients were recorded. Results The results of our study shows that a moderate correlation between free PSA and ALP values with bone metastases lesion number. In addition, we detected a weak correlation between total PSA value, free PSA/ total PSA ratio and Gleason score with the number of bone metastases lesions in patients with prostate cancer. To predict bone metastases in prostat cancer, only ALP variable was statistically significant and had a high diagnostic value (AUC = 0.907, p = 0.004). ALP cut off value was 76.50 IU/L, with %80 sensitivity and %82.1 specificity. Additionally according to our results free PSA values, total PSA values, free PSA/total PSA ratio and Gleason score values was not considered as a reliable parameter in prostate cancer cases following bone metastasis development. Conclusion According to the results of our study; the free PSA, total PSA, free PSA/total PSA ratio and Gleason score values was not considered as a reliable parameter in the prostate cancer cases follow-up for bone metastasis development. In addition to ALP can predict bone metastases with 80% sensitivity and 82.1% specificity at 76.50 cut off value.