Diagnostic value of prostate-specific antigen (PSA) and free prostate specific antigen (fPSA) in women with ovulatory an
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ORIGINAL PAPER
Diagnostic value of prostate-specific antigen (PSA) and free prostate specific antigen (fPSA) in women with ovulatory and anovulatory polycystic ovary syndrome _ ¸ Æ Halil Onder Ersoz Æ ¨ KINC Kubilay U Cihangir Erem Æ Arif Bayram Hacihasanoglu
Received: 12 September 2008 / Accepted: 21 October 2008 / Published online: 14 November 2008 Ó Humana Press Inc. 2008
Abstract Diagnosis of polycystic ovary syndrome (PCOS) is very difficult in women with ovulatory cycles. We assessed the diagnostic value of prostate-specific antigen (PSA) and free prostate-specific antigen (fPSA) in women with ovulatory or anovulatory PCOS. Study group consisted of 62 women with PCOS and 35 healthy female controls. PCOS group was divided into two subgroups as anovulatory (n = 42; 68%, Group A) and ovulatory group (n = 20; 32%, Group B). A cut-off level of PSA and fPSA was established for the sensitivity, specificity, positive likelihood ratio, area under curve, diagnostic accuracy, and positive and negative predictive values of diagnosis of PCOS. In group A, a PSA level of greater than 10 pg/ml yielded a sensitivity of 73.2%, a specificity of 80%, and a diagnostic accuracy of 73%, with a positive predictive value of 88.2% and a negative predictive value of 59.3%. An fPSA level of greater than 2.1 pg/ml yielded a sensitivity of 71.2%, a specificity of 80.4%, and a diagnostic accuracy of 87%, with a positive predictive value of 87.2% and a negative predictive value of 58.4%. In group B, a PSA level of greater than 10 pg/ml yielded a sensitivity of 65%, a specificity of 80%, and a diagnostic accuracy of 73%, with a positive predictive value of 76.5% and a negative predictive value of 69.6%. An fPSA level of greater than 2.1 pg/ml yielded a sensitivity of 65.4%, a specificity of 80.4%, and a diagnostic accuracy of 87%, _ ¸ H. O. Ersoz C. Erem A. B. Hacihasanoglu ¨ KINC K. U Department of Endocrinology and Metabolism, Karadeniz Technical University, Trabzon, TURKEY _ ¸ (&) ¨ KINC K. U Canakkale Onsekiz Mart Universitesi Tip Fakultesi Ic Hastaliklari ABD, Endokrinoloji ve Metabolizma Hastalıkları BD, 17100 C¸anakkale, Turkey e-mail: [email protected]
with a positive predictive value of 75.5% and a negative predictive value of 68.4%. Circulating androgens and hirsutism are independently associated with the degrees of PSA and fPSA in PCOS women. Increased plasma levels of PSA ([10 pg/ml) and fPSA ([2.1 pg/ml) could be helpful as a diagnostic tool for women with ovulatory or anovulatory PCOS. Keywords Hirsutism Prostate-specific antigen (PSA) Free prostate specific antigen (fPSA) Ovulatory PCOS Anovulatory PCOS
Introduction The polycystic ovary syndrome (PCOS), one of the most frequent endocrine disorders in women is a syndrome of ovarian dysfunction. Its cardinal features are hyperandrogenism and polycystic ovary morphology [1]. Its clinical manifestations may include menstrual irregularities, signs of androgen excess, and obesity. It is now recognized that women with hyperandrogenism and polycystic ovaries (PCO) ma
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