Objective      To determine the predictive value of total prostate-specific antigen (tPSA)

free prostate-specific antigen (fPSA)

ratio of fPSA to tPSA (f/tPSA)

complexed prostate-specific antigen(cPSA)and percentage of cPSA to tPSA (c/tPSA）for the Gleason score in prostate cancer (PCa).       Methods      A retrospective study was performed on 241 patients of pathologically verified PCa whose tPSA less than 100 ng/mL in our hospital from December 1

2011 to December 1

2014. The cohort was divided into 3 groups according to the standard of tPSA level

that is

＜10 ng/mL

10 ≤tPSA＜20 ng/mL and 20≤tPSA＜100 ng/mL. The relationship between the above mentioned predictors and Gleason Score (GS) in the different serum tPSA ranges was analyzed by multinomial logistic regression and receiver operating characteristic (ROC) curve.       Results      In the 214 patients

there were 69 patients (32.2%) with tPSA＜10 ng/mL

47 patients (22.0%) with it ranging from 10 to 20 ng/mL

and 98 patients (45.8%) with it between 20 to 100 ng/mL. Multivariate logistic regression analysis showed that when tPSA was under 10 ng/mL

tPSA was significantly associated with Secondary Organization Gleason Score(SGS) (P0.01)

while fPSA(P0.01) and cPSA (P0.01) were significantly associated with SGS and total Gleason Score (TGS); when it in the range of 20 to 100 ng/mL

tPSA was associated with main organization Gleason score (MGS) (P0.05)

then fPSA wasassociated with MGS

SGS and TGS (P0.01)

while f/tPSA and c/tPSA were associated with TGS (both P0.01); When tPSA ranged from 20 to 100 ng/mL

tPSA [area under curve (AUC)=0.622]

fPSA (AUC=0.639) and cPSA (AUC=0.614) had the predictive values in judging whether TGS was greater than or equal to 7.       Conclusion      When tPSA is in the range of 0 to 10 ng/mL or between 20 and 100 ng/mL

fPSA has the capability to predict the values of MGS

SGS or TGS

and is more closely associated with MGS

SGS or TGS than the other indicators.