What is the reason for a low ratio of free PSA to total PSA?

The ratio of scattered PSA to total PSA is slightly lower, and the actual ratio and the actual value of total PSA need to be determined for identification. If the total PSA is between 4-10 ng/L, and the ratio of the scattered PSA level to the total PSA is <0.16, considering the possibility of male prostate malignancy and tumor, it is recommended to conduct a follow-up visit or male prostate puncture biopsy.

If the ratio of the scattered PSA to the total PSA is >0.16, there is no need to consider the presence of a malignant tumor in the male prostate and regular follow-up can be carried out. However, if the total PSA level is >10ng/L, no matter what the ratio of the scattered PSA to the total PSA is, a follow-up visit or a prostate biopsy is required, as there may be a malignant tumor in the male prostate. Therefore, it is necessary to make a distinction based on the actual standard value, and a magnetic resonance imaging of the male prostate is required for further auxiliary distinction.

The ratio of scattered PSA to total PSA is low, and the possibility of prostate cancer should be considered. It is recommended that everyone do a prostate color Doppler ultrasound examination to confirm whether there is low echo in the cervical vein; do a male prostate MRI to find out whether there are low echo nodules in the male prostate cervical vein; do a male prostate rectal digital examination to check whether the prostate is hard and whether there is a mass. If there is hardness and a mass, it is strongly recommended that everyone do a male prostate puncture biopsy. It is strongly recommended that the puncture be performed with 14-17 needles to effectively screen whether there is a possibility of prostate cancer. A puncture biopsy is the best way to diagnose.

In clinical medicine, when performing physical examinations to check prostate-specific antigen, it is mainly used to assess the risk of prostate cancer in elderly patients. If the test results of prostate-specific antigen are between 4-10ng/mL, it is the gray value range for prostate cancer diagnosis, so the ratio of scattered to total prostate-specific antigen should be evaluated to assess the risk of prostate cancer. If the ratio is &lt;0.15, there may be a higher risk of prostate cancer; if the ratio is &gt;0.25, the risk of prostate cancer is lower. If it is close to the two, it is also necessary to perform an anal examination of the prostate and an MRI of the prostate area. If necessary, a partial prostate puncture biopsy is also required to determine the pathological type to determine whether there is a possibility of prostate cancer risk. Therefore, when the ratio is low, the patient should undergo further examination to rule out prostate cancer.