Abstract: Objective To analyze the correlation between serum PSA level,free prostate specific antigen/total rostate specific antigen(f-PSA/t-PSA) and Gleason score in prostate cancer,and to investigate the value of PSA in the diagnosis and identification of prostate cancer. Methods The clinical data of 109 cases of prostate cancer patients who were treated in urology of Shaoxing City People’s Hospital from June 2014 to September 2015 were retrospectively analyzed,and all patients were diagnosed as prostate cancer with the help of prostate biopsy guided by ultra-B.Patients were divided into different groups according to the clinical data,with/without family genetic history,and on the basis of Cancer TNM classification.The serum PSA level of patients in different family history and clinical stage was analyzed,and the correlation between serum PSA level,f-PSA/t-PSA and Gleason score in prostate cancer was evaluated. Results The mean serum PSA level of patients with a family history of prostate cancer was(323.59±267.15)ng/ml,higher than that of no family history,(198.11±100.22)ng/ml,P<0.05,and the difference was statistically significant.The serum PSA level in patients with different clinical stages were quite different,lowest in Ⅰ period,(6.28±4.08)ng/ml,highest in Ⅳ period(459.08±123.01)ng/ml.The serum PSA level of prostate cancer was positively correlated with prostate tissue biopsy Gleason score(r=0.367,P＜0.001).Mean serum free/total prostate-specific antigen in patients with poorly differentiated carcinoma was 0.145±0.017,differentiation of carcinoma was 0.225±0.021,well differentiated carcinoma was 0.345±0.104,and prostate cancer pathological Gleason score was negative correlated to serum f-PSA/t-PSA(r=-0.378,P=0.008). Conclusion The serum prostaglandin specific antigen was correlated with Gleason score,and serum PSA level was important for the clinical diagnosis and treatment of prostate cancer,and it should be included in the screening program for prostate cancer.