Serum Prostate-Specific Antigen and Prostate Pathology in Men Having Simple Prostatectomy

Abstract

Prostate-specific antigen (PSA) is a sensitive and specific serum marker for monitoring disease activity in men with prostatic carcinoma. Despite reports of elevation of levels of this analyte in men with benign prostatic hyperplasia, no information is available correlating the serum levels with the actual prostatic abnormalities in men having prostatectomy for presumed benign disease. In the present investigation, the authors compared preoperative serum PSA levels with prostate disease in 81 men with bladder outlet obstruction. Five pathologic groups were found: incidental high-grade carcinoma (n = 3), low-grade carcinoma (n = 11), acute inflammation (n = 16) with or without chronic inflammation, Prostatic intraepithelial neoplasia (PIN) (n = 25), and benign hyperplasia (n = 26). Serum PSA levels were significantly elevated in both low- and high-grade carcinoma, acute inflammation, and PIN when compared with the patients with benign hyperplasia with and without chronic inflammation. Within the four groups with elevated levels, use of PSA levels could separate only the high-grade cancer patients who were subsequently shown to have metastatic disease. Only one patient with simple hyperplasia had PSA levels in the abnormal range.

Ratio of Free to Total Prostate-Specific Antigen in Patients with Prostatic Intraepithelial Neoplasia

“…Conversely, Alexander et al [27]evaluated radical prostatectomy specimens and found that high-grade PIN volume did not contribute to serum PSA concentration. Our findings are compatible with the reports of Brawer et al [25]and Bostwick et al [26]. We demonstrated that tPSA values in patients with PIN were higher than the patients with BPH and lower than the patients with CaP.…”

“…Brawer et al [25]studied the correlation of preoperative serum PSA levels between BPH and PIN in patients who underwent simple prostatectomy. The mean serum PSA value was 5.6 ng/ml for patients with isolated PIN, 2.1 ng/ml for those with benign disease, and 35.1 ng/ml for patients with carcinoma.…”

Prostate specific antigen: biology, biochemistry and available commercial assays

“…It is the disruption of this barrier by disease which allows an in¯ux of PSA into the systemic circulation. 1 Embryologically, while the prostate utricle is derived from the MuÈ llerian tubes (equivalent of the vagina), the majority of the gland is derived from the uro-genital sinus. This is an androgendependent process.…”

Percent of Free Serum Prostate-Specific Antigen and Histological Findings in Patients Undergoing Open Prostatectomy for Benign Prostatic Hyperplasia

“…Although several reports have suggested that BPH and prostatic inflammation contribute to an increase in total serum PSA concentration [11, 12, 13, 14, 15, 16], it remains to be proved whether the presence of pathologically abnormal areas of the prostate affected by BPH allow leakage from the prostatic acini and ductule lumen into the systemic circulation and thus increase the serum F-PSA and total PSA (T-PSA) concentrations.…”