scholarly journals Prostatic Lesion and Its Relation with Serum Concentration of PSA

KYAMC Journal ◽  
2020 ◽  
Vol 11 (1) ◽  
pp. 42-45
Author(s):  
Abu Sazzad Muhammad Fazlul Haque ◽  
Abu Sharif Mohammad Akramul Islam ◽  
Sailendranath Biswas ◽  
Md Faisal Kabir

Background: Prostate-specific antigen (PSA) is a protein produced by the cells of the prostate gland. It is generally increased in diseases such as prostatitis, hyperplasia and malignancy, but the correlation between various pathology affecting the prostate gland and their corresponding rise in PSA values is not constant, and exception may occur. Objectives: The aim of this study was to find out the spectrum and distribution of various prostatic lesions affecting men, with respect to their age and to find out the correlation between serum total PSA and histological findings. Materials and Method: From January 2016 to March 2019, a total of 166 patients in the age group of 39-95 years who underwent histopathology. The reports were studied retrospective and prospectively. Of these patients, 63 were being nodular hyperplasia of prostate. 70 were with existing prostatitis and 33 were adenocarcinoma. The PSA levels were estimated in our Biochemistry Department. Results: The cases were distributed in the age group 39 to 95years.The patient of adenocarcinoma was 33 and its mean value of PSA was 1164.19 ng/ml, in case of prostatitis number of patient was 70 and its mean value was 12.74ng/ml, prostatic hyperplasia patient was 63 and mean value was 5.2ng/ml. Conclusion: The result indicate that the chances of malignancy with increasing value of PSA are more but not a rule. It can only give a clue to the histopathologist to examine the sections more thoroughly. KYAMC Journal Vol. 11, No.-1, April 2020, Page 42-45

1999 ◽  
Vol 45 (11) ◽  
pp. 1960-1966 ◽  
Author(s):  
Angeliki Magklara ◽  
Andreas Scorilas ◽  
William J Catalona ◽  
Eleftherios P Diamandis

Abstract Background: Prostate-specific antigen (PSA) is the most reliable tumor marker available and is widely used for the diagnosis and management of prostate cancer. Unfortunately, PSA cannot distinguish efficiently between benign and malignant disease of the prostate, especially within the range of 4–10 μg/L. Among the refinements developed to enhance PSA specificity is the free/total PSA ratio, which is useful in discriminating between the two diseases within the diagnostic “gray zone”. Recent data indicate that human glandular kallikrein (hK2), a protein with high homology to PSA, may be an additional serum marker for the diagnosis and monitoring of prostate cancer. Methods: We analyzed 206 serum samples (all before treatment was initiated) from men with histologically confirmed benign prostatic hyperplasia (n = 100) or prostatic carcinoma (n = 106) with total PSA in the range of 2.5–10 μg/L. Total and free PSA and hK2 were measured with noncompetitive immunological procedures. Statistical analysis was performed to investigate the potential utility of the various markers or their combinations in discriminating between benign prostatic hyperplasia and prostatic carcinoma. Results: hK2 concentrations were not statistically different between the two groups of patients. There was a strong positive correlation between hK2 and free PSA in the whole patient population. hK2/free PSA ratio (area under the curve = 0.69) was stronger predictor of prostate cancer than the free/total PSA ratio (area under the curve = 0.64). At 95% specificity, the hK2/free PSA ratio identified 30% of patients with total PSA between 2.5–10 μg/L who had cancer. At 95% specificity, the hK2/free PSA ratio identified 25% of patients with total PSA between 2.5 and 4.5 μg/L who had cancer. Conclusions: Our data suggest that hK2 in combination with free and total PSA can enhance the biochemical detection of prostate cancer in patients with moderately increased total PSA concentrations. More specifically, the hK2/free PSA ratio appears to be valuable in identifying a subset of patients with total PSA between 2.5 and 4.5 μg/L who have high probability of cancer and who should be considered for biopsy.


2000 ◽  
Vol 46 (1) ◽  
pp. 47-54 ◽  
Author(s):  
Klaus Jung ◽  
Brigitte Brux ◽  
Michael Lein ◽  
Birgit Rudolph ◽  
Glen Kristiansen ◽  
...  

Abstract Background: Patients with prostate cancer (PCa) show a lower ratio of free prostate-specific antigen (fPSA) to total PSA (tPSA) in serum than patients with benign prostatic hyperplasia (BPH). The patterns of the intracellular PSA isoforms in malignant and benign prostatic tissue have been studied as potential molecular reasons for this phenomenon. Methods: Prostatic tissue samples were obtained after cystoprostatectomy from patients with bladder cancer (n = 10), from BPH patients (transurethral resection of the prostate, n = 10; adenomectomy, n = 10), and from the cancerous and noncancerous parts of the same prostates removed surgically by prostatectomy because of PCa (n = 20). PSA pattern was characterized by gel filtration, immunoblotting, and immunoassays for tPSA, fPSA, α1-antichymotrypsin-PSA (ACT-PSA), and complexed PSA (Bayer Immuno 1 assay). Comparisons were made with the PSA concentrations in serum. Results: The major portion of tPSA in all tissue samples was fPSA; complexed PSA forms were <2%. Samples from cystoprostatectomy patients had the lowest and those from adenomectomy patients the highest values of tPSA and fPSA. PSA concentrations were lower in cancerous than in the noncancerous parts of the prostate. No significant correlations were found between tumor stage or grade and the amounts of tPSA, fPSA, and ACT-PSA in tissue. Tissue PSA values were not correlated with the serum PSA concentrations nor with the ratios fPSA/tPSA and ACT-PSA/tPSA in sera. Conclusions: The amounts of tPSA and the PSA isoforms in prostatic tissue explain neither the concentrations of tPSA and PSA isoforms in serum nor the behavior of the ratio fPSA/tPSA in patients with BPH and PCa.


2002 ◽  
Vol 48 (8) ◽  
pp. 1251-1256 ◽  
Author(s):  
Manuel Martínez ◽  
Francisco España ◽  
Montserrat Royo ◽  
José M Alapont ◽  
Silvia Navarro ◽  
...  

Abstract Background: The aim of this study was to assess the diagnostic accuracy of the proportion of prostate-specific antigen (PSA) complexed to α1-antichymotrypsin (PSA-α1ACT:PSA ratio) in the differential diagnosis of prostate cancer (CaP) and benign prostatic hyperplasia (BPH) in men with total PSA of 10–30 μg/L. Methods: We used our immunoassays (ELISAs) for total PSA and PSA-α1ACT complex to study 146 men. In 123, total PSA was between 10 and 20 μg/L; 66 of these had CaP and 57 BPH. In 23 men, total PSA was between 20 and 30 μg/L; 14 of these had CaP and 9 BPH. We calculated the area under the ROC curves (AUC) for total PSA, PSA-α1ACT complex, and PSA-α1ACT:PSA ratio, and determined the cutoff points that gave sensitivities approaching 100%. Results: In the total PSA range between 10 and 20 μg/L, the AUC was significantly higher for the PSA-α1ACT:PSA ratio (0.850) than for total PSA (0.507) and PSA-α1ACT complex (0.710; P <0.0001). A cutoff ratio of 0.62 would have permitted diagnosis of all 66 patients with CaP (100% sensitivity) and avoided 19% of unnecessary biopsies (11 of 57 patients). In the total PSA range between 20 and 30 μg/L, the AUC for the PSA-α1ACT:PSA ratio (0.980; 95% confidence interval, 0.82–0.99) was greater than the AUC for total PSA (0.750; 95% confidence interval, 0.51–0.89; P = 0.042). In this range, a cutoff point of 0.64 would have permitted the correct diagnosis of all 14 patients with CaP and 6 of the 9 with BPH. Conclusions: The diagnostic accuracy of the PSA-α1ACT:PSA ratio persists at high total PSA concentrations, increasing the specificity of total PSA. Prospective studies with large numbers of patients are needed to assess whether the ratio of PSA-α1ACT to total PSA is a useful tool to avoid unnecessary prostatic biopsy in patients with a total PSA >10 μg/L.


2013 ◽  
Vol 15 (2) ◽  
pp. 14-24
Author(s):  
Puji Widayati ◽  
Gina Mondrida ◽  
Sri Setiyowati ◽  
Agus Ariyanto ◽  
V. Yulianti Susilo ◽  
...  

Prostate Specific Antigen (PSA) is a glycoprotein with a molecular weight of approximately 34,000 daltons serine protease secreted exclusively by prostatic epithelial cells that lining acini and prostate gland. Increased of PSA levels can be caused by prostate cancer or benign prostate enlargement (benign prostatic hyperplasia, BPH). PSA in the blood was found in the free condition (free PSA) and most of the bound protein (complexed-PSA, c-PSA). Measuring levels of PSA was found in the blood can be done by several methods such as by immunoradiometricassay (IRMA) methods or ELISA methods. IRMA method is one of immunoassay techniques using radionuclides ,/' 125 oJ I as a tracer, so the sample in small 13 quantity can be detected The purpose of this study was obtained PSA reagent kit that includes 1251labeled PSA as a tracer, PSA coated tube and PSA standard that requirements of the kit, then it can be optimized assay design, that eventually PSA reagent kit can be used for early detection of prostate cancer. It has been done labeling of Mab PSA using 125 1with reaction time was 90 seconds, amount of PSA MAb was 75 ugram and the activity of Na_ 125I was 1000 flCi. Preaparation of PSA coated tube using 0.05 M Na2C03 solution, at pH: 9.6 with volume was 250 ml., standard PSA with 0.025 Mphosphate buffer at pH 7.4 containing 5% BSA and 0.1% NaN3, and resulting at 1,25% and 14,12% respectively of NSB and BIT that requirement of the kit.Keywords: Prostate cancer, PSA, IRMA,NSB, Maximum Binding


2016 ◽  
Vol 5 (1) ◽  
pp. 14-19
Author(s):  
Rupesh Kumar Shreewastav ◽  
Chandra Prakash Gaire ◽  
Ashima Ghimire ◽  
Prashant Kumar Shah ◽  
Arambam Giridhari Singh

Background A study was conducted to evaluate Prostate specific antigen (PSA) level in different age group of patients in Nobel Medical College Teaching Hospital (NMCTH), Biratnagar, Eastern Nepal.Material and Methods A total of 1870 male patients (age 51-88), attending OPD in different departments of NMCTH, were sent to Clinical Laboratory Services for estimation of Prostate specific antigen from 1st January 2013 to 30thJune 2014 and recruited for this study after Institutional ethical approval. Blood serum of these patients was tested for Prostate specific antigen level by Chemiluminescence Immunoassay (CLIA). Mean value and standard deviation were calculated using Student’s two–tailed t–test. Analysis of data was performed using one– way ANOVA. Results are considered statistically significant if p ≤0.05.Results Out of 1870 patients, 178 patients showed significantly higher level of PSA in their serum when compared to normal individuals. Out of this 178, 37 were from age group of 51-60, 51 were from age group of 61-70, 42 were from age group of 71-80 and 48 were from age group of 81-88. The remaining 1692 patients were having PSA within normal limit. PSA was found to be elevated up to a maximum of 34.5 ng/ml in patient. PSA level of <4 ng/ml was considered normal for this study.Conclusion This study, thus determines the diagnostic level of PSA, in different age group of patients comparing with normal individuals in eastern Part of Nepal that can help in diagnosis, prognosis and management of prostate cancer.Journal of Nobel Medical College Volume 5, Number 1, Issue 8, January-July 2016, 14-19 


2021 ◽  
Vol 6 (2) ◽  
pp. 1556-1560
Author(s):  
Chandra Prakash Gaire

Introduction: The periurethral and transition zones of the prostatic gland develop benign prostatic hyperplasia and represent an inevitable phenomenon for the ageing male population. Prostatic specific antigen, is a serine protease, level rises in the blood if the barrier between thelining epithelium and the blood stream is damaged. Benign prostatic hyperplasia, prostatic carcinoma and prostatitis are three common diseases where PSA in the serum is raised. Prostate volume also increases according to age, which can be estimated by trans-abdominal ultrasonography. Objective: The aim of the study is to estimate the PSA level in blood and its relationship with prostate volume in benign prostatic hyperplasia patients. Methodology: It is a descriptive cross-sectional study which was carried out between a periods of 1st April 2018 to 31st March 2019 at Birat Medical College Teaching Hospital. All the patients diagnosed with benign prostate hyperplasia at the department of urology were included in the study. Blood samples of patients were analyzed for Prostate specific antigen level estimation by chemiluminescence immunosorbent assay. Prostatic volume of the patients was measured by Transabdominal ultrasound technique. Data were entered and analyzed in Microsoft Excel. Results: A total of 68 patients were diagnosed with benign prostate hyperplasia. The mean age of the patients was 61.8±12.3 years. The maximum number 23 of patients with BPH was there in age group 51-60. The maximum no of patients 38 were having their PSA level between the range of 4.0-10.0 ng/ml. The maximum no of patients 28 was having Prostate volume in the range of 40-60 gm. The maximum number of patients 31 was having diabetes mellitus as a co-morbid association. The maximum mean PSA level and prostate volume in the patients were observed in age group >80 years,which was 20.1±8.6 ng/ml and >80 gm respectively. Conclusion: The prostate specific antigen level and prostate volume both increase in advance age group of patients suffering with benign prostate hyperplasia.


2017 ◽  
Vol 7 (1) ◽  
pp. 1074-1077 ◽  
Author(s):  
S Hirachand ◽  
UMS Dangol ◽  
S Pradhanang ◽  
S Acharya

Background: Diseases primarily inflicting prostate gland are inflammation, benign prostatic hyperplasia and cancer. Prostate specific antigen is a protein produced by the cells of prostate gland. It has been widely used in the diagnosis and management of patients with prostatic cancer. The aim this study was to determine the correlation between serum prostate specific antigen level and histological findings in biopsy specimens of men with prostatic disease.Materials and methods: This study was carried out at Kathmandu Medical College and Teaching Hospital, department of Pathology over a period of 2 years. One hundred and twenty eight cases with prostatic lesions were included in this study. Prostate specific antigen values of these cases were recorded before the surgical process. Histology of the tissue samples collected after transurethral resection of prostate was studied and relationship with prostate specific antigen level were analyzed.Results: Benign prostatic hyperplasia was the most common histological lesion encountered (n=95; 74.22%). Prostatic adenocarcinomas were seen a decade older than those with benign lesions. Maximum number of the benign cases had the Prostate specific antigen range of 0-7ng/ml. Most of the prostatic intraepithelial neoplasia lesions were seen within the PSA range of 0-7ng/ml and adenocarcinoma in the range of >20ng/ml.Conclusion: Prostate specific antigen is specific for the prostate but not for prostate cancer. Both benign and malignant lesions in prostate can cause increase in serum prostate specific antigen levels, but the chances of malignancy it rising level. 


Author(s):  
Sanjay Patidar ◽  
Kritika Kamal ◽  
Jaydip Sinh Kathota ◽  
Sudhanshu Tiwari ◽  
Prashant Nakrani

Background: In clinical practice, biopsies are generally performed only when the results ofprostate specific antigen (PSA) test or digital rectal examination (DRE) are abnormal. This leads to misdiagnosis of most small prostatic cancers present in many older men. Patients with lower urinary tract infection (LUTS) who have serum PSA levels higher than 4ng/ml are primarily advised to undergo prostate biopsy to rule out cancer. However, PSA is organ specific not disease specific, so the presence of other prostate diseases such as benign prostatic hyperplasia (BPH) and prostatitis may influence its effectiveness for cancer detection. Hence, the PSA based prostate cancer detection is fraught with high false positive rate. Aim:To evaluate the utility of PSA assay as a method of investigation in diagnosis of prostatic lesion. Objectives: The use of Serum PSA levels for the early detection of prostate cancer and evaluate its role with other modalities for diagnosis of prostate cancer and to diagnose different diseases of prostate, i.e. prostatitis, BPH in prostatomegaly, and its correlation with Serum PSA levels. Materials and Methods: This prospective descriptive study was conducted in Index Medical College, Hospital & Research Centre, Indore, M.P,India in the period of August 2019 to July 2021. The patients were selected from the outdoor Department of General Surgery. Results: A total of 80 male patients presenting with LUTS were included. Their mean age was 68.66 years. The majority i.e. 41 of the study group were in the age group of 61-70 years. 42 of patients had Serum PSA < 4ng/ml. Biopsy proven adenocarcinoma cases 34% of the cases are in the age group of 61-70 years. Out of the biopsy proven adenocarcinoma cases, DRE was suspicious of malignancy in 89%. Conclusion: Serum PSA levels have a significant correlation with the age group, with the increase in age there is rise in Serum PSA levels. Transabdominal ultrasound, DRE and Serum PSA has high sensitivity in diagnosis of prostatomegaly but it was found that none of the screening tool has got much efficacy in differentiating carcinoma prostate from benign hypertrophy, but the combination of DRE and Serum total PSA or DRE, Serum total PSA and ultrasound abdomen showed higher efficacy in diagnosis of carcinoma prostate. Increase in Serum PSA is directly related to carcinoma, but there is no absolute cut-off for Serum PSAfor diagnosis of carcinoma. Key-Words: Prostate specific antigen, Prostatomegaly, Benign Prostatic Hypertrophy, Digital Rectal Examination, International Prostate Severity Score, Carcinoma Prostate.


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