Evaluación del riesgo de cáncer prostático mediante el cociente entre PSA libre y PSA total
Palabras clave:
Antígeno prostático específico, PSA libre, PSA total, cáncer de próstata, estratificación del riesgoResumen
DOI: https://doi.org/10.46296/gt.v9i18edespsep.0451
Resumen
El cáncer de próstata constituye un problema relevante en la población masculina adulta y su evaluación requiere herramientas que permitan estimar el riesgo sin atribuir capacidad diagnóstica a un biomarcador aislado. El objetivo de esta investigación fue evaluar el riesgo de cáncer prostático mediante el cociente entre PSA libre y PSA total en hombres adultos atendidos en el Laboratorio Clínico San Juan de Salcedo. Se realizó un estudio cuantitativo, no experimental, transversal y descriptivo en 30 participantes mayores de 40 años seleccionados mediante muestreo no probabilístico intencional. Las concentraciones séricas de PSA total y PSA libre se determinaron mediante inmunoensayo automatizado por quimioluminiscencia; posteriormente se calculó el porcentaje de PSA libre y se efectuó la estratificación analítica del riesgo. El PSA total presentó una media de 5,95 ± 2,26 ng/mL, el PSA libre de 1,29 ± 0,50 ng/mL y el porcentaje de PSA libre de 21,83 ± 3,45 %. El 73,3 % de los participantes se ubicó entre 4,0 y 10,0 ng/mL de PSA total, mientras que el 26,7 % registró un porcentaje de PSA libre inferior al 20 % y fue clasificado en la categoría de mayor riesgo analítico. La edad se correlacionó de forma positiva con el PSA total (r = 0,560; p = 0,001) y con el PSA libre (ρ = 0,537; p = 0,002), pero no con el porcentaje de PSA libre (r = −0,025; p = 0,894). Se concluye que el cociente PSA libre/PSA total aporta información complementaria para estratificar el riesgo, especialmente en valores intermedios de PSA total, aunque no sustituye la valoración clínica ni la confirmación diagnóstica.
Palabras claves: Antígeno prostático específico, PSA libre, PSA total, cáncer de próstata, estratificación del riesgo.
Abstract
Prostate cancer is a relevant health problem in adult men, and its assessment requires tools that estimate risk without assigning definitive diagnostic capacity to a single biomarker. This study aimed to assess prostate cancer risk using the free-to-total prostate-specific antigen (PSA) ratio in adult men evaluated at the San Juan Clinical Laboratory in Salcedo. A quantitative, non-experimental, cross-sectional, descriptive study was conducted in 30 participants older than 40 years selected through non-probability purposive sampling. Serum total PSA and free PSA concentrations were measured using automated chemiluminescent immunoassay; the percentage of free PSA was then calculated and used for analytical risk stratification. Mean total PSA was 5.95 ± 2.26 ng/mL, mean free PSA was 1.29 ± 0.50 ng/mL, and mean percentage of free PSA was 21.83 ± 3.45%. A total of 73.3% of participants had total PSA values between 4.0 and 10.0 ng/mL, while 26.7% had a free PSA percentage below 20% and were classified in the higher analytical-risk category. Age showed a positive correlation with total PSA (r = 0.560; p = 0.001) and free PSA (ρ = 0.537; p = 0.002), but not with the percentage of free PSA (r = −0.025; p = 0.894). The free-to-total PSA ratio therefore provides complementary information for risk stratification, particularly when total PSA values are intermediate, but it does not replace clinical assessment or diagnostic confirmation.
Keywords: Prostate-specific antigen, free PSA, total PSA, prostate cancer, risk stratification.
Información del manuscrito:
Fecha de recepción: 23 de junio de 2026.
Fecha de aceptación: 15 de agosto de 2026.
Fecha de publicación: 23 de septiembre de 2026.
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Derechos de autor 2026 Revista Científica Arbitrada en Investigaciones de la Salud GESTAR. ISSN: 2737-6273.
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