Extraprostatic Production of Prostate Specific Antigen is Under Hormonal Control

Breul, Jürgen; Pickl, Ulrich; Schaff, J.

doi:10.1097/00005392-199701000-00065

Cited by 8 publications

(12 citation statements)

References 13 publications

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“…The 42 patients with prostate cancer underwent radical prostatectomy and there was no difference in urinary PSA between lower (4-6) and higher (7)(8)(9) Gleason scores (median 49 ng/mL and 70 ng/mL, respectively; p = 0.40). The staging capacity was assessed and patients with stage T1 (n = 5) and T2 (n = 21) tumours had similar serum and urinary PSA as well as PSA ratios (p > 0.20); therefore, they were pooled together to be compared with stage T3 tumours.…”

Section: Resultsmentioning

confidence: 93%

“…Over the years, PSA has been measured on different samples: in urine voided before and after prostate massage, 3,4 in first-voided urine, [4][5][6] in single midstream sample of urine [7][8][9][10] and in 24-hour urine specimens. [11][12][13] The fact that a urine specimen contains more PSA certainly appears to be an advantageous issue in terms of method of choice for PSA measurement.…”

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confidence: 99%

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Urinary PSA: a potential useful marker when serum PSA is between 2.5 ng/mL and 10 ng/mL

Bolduc

Lacombe

Naud

et al. 2013

CUAJ

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Urinary PSA: a potential useful marker when serum PSA is between 2.5 ng/mL and 10 ng/mL ORIGINAL RESEARCH Abstract Introduction: Our objective was to evaluate the usefulness of urinary prostate specific antigen (PSA) in the differential diagnosis of benign prostatic hyperplasia (BPH) and prostate cancer. Methods:We undertook a prospective study and obtained informed consent from 170 men. They provided blood samples to measure serum PSA and 50 mL of firstvoided urine to measure urinary PSA. Seventy-seven men were diagnosed with BPH; 42 patients had newly diagnosed prostate cancer; and 51 were selected as age-matched control subjects. Data were analyzed using Wilcoxon signed rank tests, receiver operating characteristic (ROC) curves and logistic regression. Results:Prostate volume was 35 cm 3 and 45 cm 3 (p < 0.05), serum PSA was 9.7 ng/mL and 4.5 ng/mL (p < 0.001) and PSA density was 0.28 and 0.11 (p < 0.01) for prostate cancer and BPH patients, respectively. Overall, urinary PSA was not significantly different, but PSA ratio (urinary:serum) was significantly different at 6.7 and 30.6 (p < 0.001) for prostate cancer and BPH patients, respectively. A subgroup with serum PSA between 2.5 ng/mL and 10.0 ng/mL was selected and urinary PSA was significant: 52.6 ng/mL (n = 29) and 123.2 ng/mL (n = 35) (p < 0.05) for prostate cancer and BPH patients, respectively. PSA ratios were also significant (p = 0.007). ROC curves identified a cutoff for urinary PSA at > 150 ng/mL, with a sensitivity of 92.5%. When comparing prostate cancer patients with age-matched control subjects, serum PSA, urinary PSA and PSA ratio were different (p = 0.004). Conclusion:Our study supports urinary PSA as a useful marker in the differential diagnosis of prostate cancer and BPH, especially when serum PSA is between 2.5 ng/mL and 10 ng/mL. Low urinary PSA and PSA ratios point toward prostate cancer. A urinary PSA threshold of > 150 ng/mL may be used to decrease the number of prostatic biopsies. IntroductionSerum prostatic specific antigen (PSA) has proven to be a generally reliable indicator in the diagnosis and management of prostate cancer. It has revolutionized the management and follow-up of prostate cancer since its clinical introduction in the late 1980s. Serum PSA remains the best single test for the detection of early prostate cancer, and multiple variations have been studied to improve its sensitivity and speci- either urinary tract infection or symptoms of prostatitis. Patients were consecutively recruited during a scheduled clinic visit either before a transrectal ultrasound (TRUS) and biopsies (minimum of 8 core biopsies) for abnormal serum PSA or digital rectal exam (or both); or patients who had an established diagnosis of prostate cancer were recruited for participation when they presented for preadmission before a scheduled radical prostatectomy.A total of 170 men gave an informed written consent and provided blood samples to measure serum PSA and bioavailable testosterone (normal range 2-14 nmol/L), which was analyzed in our labor...

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Section: Resultsmentioning

confidence: 93%

mentioning

confidence: 99%

Urinary PSA: a potential useful marker when serum PSA is between 2.5 ng/mL and 10 ng/mL

Bolduc

Lacombe

Naud

et al. 2013

CUAJ

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show abstract

“…Androgenic therapies established for female to male transsexuals led to elevated levels of serum PSA comparable with the results of increased urinary PSA levels secondary to long‐term testosterone treatments used in the same group of patients 14–16 . All those data concluded that there is a link between increased androgen levels and PSA values measured in serum or urine.…”

Section: Introductionmentioning

confidence: 73%

“…However, estrogen may impair indirectly the androgen‐induced PSA production 9,27,31 . Both serum and urine PSA levels are also reported to be elevated in response to long‐term androgenic (Testosterone) therapy in female‐to‐male transsexuals 14,16 . Additionally, a number of authors such as Melegos and Escobar‐Morrale concluded that hirsute females with hyperandrogenism presented clearly elevated serum PSA levels when compared to control cases 9,32,33 .…”

Section: Discussionmentioning

confidence: 99%

Is prostate‐specific antigen a potential new marker of androgen excess in polycystic ovary syndrome?

Vural

Özkan

Bodur

2007

J of Obstet and Gynaecol

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PSA is a well-established tumor marker of prostatic adenocarcinoma. It is also shown to be produced by extraprostatic tissues and fluids. As the gene expression of PSA is upregulated by the androgens and progestins in hormonally responsive tissues, hyperandrogenic syndromes such as PCOS may be associated with elevated serum PSA levels. PSA appears to be a promising marker of endogenous androgen excess in females suffering from PCOS.

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“…A recent study documented that the concentration of PSA in cord blood is higher in case of higher gestational age, male baby and operative delivery and explained that higher progesterone levels in prenatal maternal blood having male babies may be responsible for the higher cord blood PSA while operative interventions like caesarian section or forceps delivery results in much more stress and strain compared to normal vaginal delivery, with subsequent increase in levels of adrenal glucocorticoids, and therefore, higher cord blood PSA [54]. Breul et al [55] reported that female patients receiving Testosterone supplementation has PSA levels comparable with that of men with significantly elevated urinary PSA levels presumably as a result of increased production of PSA by the periurethral glands. These studies reveal that PSA production is upregulated by androgens.…”

Section: Psa In Femalesmentioning

confidence: 99%

Reconnoitring the Status of Prostate Specific Antigen and its Role in Women

Dash

2014

Ind J Clin Biochem

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Extraprostatic Production of Prostate Specific Antigen is Under Hormonal Control

Abstract: Our data demonstrate that extraprostatic PSA production is under androgen control.

Cited by 8 publications

References 13 publications

Urinary PSA: a potential useful marker when serum PSA is between 2.5 ng/mL and 10 ng/mL

Urinary PSA: a potential useful marker when serum PSA is between 2.5 ng/mL and 10 ng/mL

Is prostate‐specific antigen a potential new marker of androgen excess in polycystic ovary syndrome?

Reconnoitring the Status of Prostate Specific Antigen and its Role in Women

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