OBJECTIVESTo assess the effect of transrectal prostatic biopsy (TPB) on the concentrations of serum prostate specific antigen (PSA).

METHODSTwenty patients with abnormal PSA levels and/or digital rectal examination (DRE) underwent TPB. Serum PSA levels were measured before TPB and at 0.5 h, 1 week, 1 month after TPB, respectively.

RESULTSThe serum PSA levels before TPB and 0.5 h, 1 week, 1 month after TPB were (12.23 +/- 8.62), (34.90 +/- 41.53), (23.59 +/- 20.78) and (11.31 +/- 6.95) micrograms/L, respectively. The serum PSA concentration was significantly higher at 0.5 h after TPB than before (P < 0.05), and then gradually decreased. PSA levels remained higher for at least 1 week in 85% (17/20) patients(P < 0.05), then returned to the baseline at one month after TPB (P > 0.05).

CONCLUSIONSTPB can lead to a dramatic increase of PSA in serum and keep the PSA value high in one week. Then the PSA in serum decreased gradully. Serum PSA level cannot return to baseline until one month after TPB.

Biopsy ; Humans ; Male ; Prostate ; pathology ; Prostate-Specific Antigen ; blood

PSA-based screening has always been one of the controversial topics among urological researchers. In spite of its benefit in detecting early prostate cancer, PSA-based screening may not only result in widespread overdiagnosis and overtreatment of an often indolent disease, which is life-threatening in only a minority of patients, but also subject participators to such complications as erectile dysfunction and incontinence. Besides, whether PSA-based screening can reduce prostate cancer specific mortality has received considerable attention. This review offers a comparative analysis of recent studies on PSA-based screening for prostate cancer.
Humans ; Male ; Prostate-Specific Antigen ; blood ; Prostatic Neoplasms ; blood ; diagnosis

To assess whether the free-to-total prostate specific antigen (PSA) ratio (F/T PSA ratio) would enhance prostate cancer detection in Korean men with serum total PSA levels between 4 and 20 ng/ml. Methods: A total of 240 consecutive patients whose serum PSA levels were between 4 and 20 ng/ml were enrolled in this two-year study. All patients underwent ultrasound-guided transrectal biopsies of the prostate gland. The F/T PSA ratio was measured using the Roche immunoassay. Results: Of the 240 patients, 202 (84%) had benign histologies, while 38 (16%) had prostate cancer. The two patient groups were well matched for age. The mean F/T PSA ratio showed a statistically significant difference between the two groups: in the benign histology group it was 0.14 (0.04 - 0.37), and 0.10 (0.08 - 0.20) in the prostate cancer group (p< 0.05). Out of the 183 patients with a PSA level between 4-10ng/ml, the mean F/T PSA ratios were 0.14 and 0.11 in the benign histology (n=158) and prostate cancer groups (n=25), respectively (p< 0.05). From the 57 patients with a PSA level between 10 - 20 ng/ml, the mean F/T PSA ratios were 0.14 and 0.10 in the benign histology (n=44) and prostate cancer groups (n=13), respectively (p< 0.05). Overall, when the cut-off value of the F/T PSA ratio was 0.10, the sensitivity and specificity were 75.0% and 76.5%, while for the cut-off value of 0.15 they were 83.3% and 39.7% respectively. Conclusion: Our data demonstrated the usefulness of the free to total PSA ratio in distinguishing benign prostate disease and cancer disease, hence eliminating unnecessary biopsies. It is recommended that a cut-off value for the F/T PSA ratio of 0.10 be applied to Korean men which this is lower than the value used in Western countries.
Biopsy ; Humans ; Male ; Middle Aged ; Prostate/pathology ; Prostate-Specific Antigen/*blood ; Prostatic Neoplasms/*diagnosis ; ROC Curve

Serum prostate-specific antigen (PSA) is composed of the PSA precursor protein (proPSA) in the absence of the leader peptide induced by human kallikrein 2 (hK2). There are many forms of PSA in the blood, including free PSA and bound PSA. Serum proPSA, as a free PSA, has many isoforms, among which, [-2]proPSA (p2PSA) cannot be activated by hK2 and therefore exists stably in the blood. Serum p2PSA is a homologous isomer of PSA. Serum prostate health index and % p2PSA, as the derivative indexes of p2PSA and molecular markers associated with the development and progression of prostate cancer, can reduce serum PSA test-induced excessive diagnosis and treatment of the malignancy and improve the accuracy of its prediction. This review summarizes recent progress in the studies of serum p2PSA and its derivative indexes in prostate cancer.
Humans ; Male ; Prostate-Specific Antigen ; blood ; Prostatic Neoplasms ; blood ; immunology ; Protein Isoforms ; blood

PURPOSE: Several studies have shown that finasteride limits hematuria in patients with benign prostatic hyperplasia(BPH). However, there are few reports addressing dutasteride therapy. We evaluated the effect of dutasteride on intraoperative blood loss and on microvessel density(MVD) in patients with BPH. MATERIALS AND METHODS: We studied 39 patients with BPH who underwent transurethral resection of the prostate(TURP). Group I included 22 patients who received dutasteride 0.5mg daily for 2 weeks preoperatively, and group II included 17 patients who did not. Blood loss was evaluated by comparing preoperative and postoperative hemoglobin. Sections from the prostatic suburothelium and hyperplastic prostate were individually stained for CD 34. MVD was calculated by counting the number of positively stained blood vessels in 5 random high power fields. There were no significant differences between the groups in terms of age, total prostatic volume, resected prostatic weight, or prostate-specific antigen (PSA). RESULTS: The mean MVD in the suburethral portion in dutasteride-treated patients was significantly lower than that seen in untreated patients(14.47 versus 22.19 vessels per high power field, p=0.026). In nodular hyperplasia, there was no significant difference in MVD between the two group(14.72 versus 15.24 vessels per high power field, p=0.801). CONCLUSIONS: Short term pretreatment with dutasteride decreases suburethral prostatic MVD in patients with BPH and may help reduce blood loss during TURP, particularly in huge BPH, which sometimes bleeds excessively during operation.
Azasteroids ; Blood Vessels ; Finasteride ; Hematuria ; Hemoglobins ; Humans ; Hyperplasia ; Microvessels ; Prostate ; Prostate-Specific Antigen ; Prostatic Hyperplasia ; Transurethral Resection of Prostate ; Dutasteride

OBJECTIVETo investigate the relationship of the histopathologic grade and extent of prostatic inflammation with the level of serum PSA in patients with type IV prostatitis.

METHODSWe performed transrectal ultrasound-guided prostate biopsy for 120 patients suspected of prostate cancer and included in this study only those with benign prostate hyperplasia (BPH) and prostatitis (n = 46), excluding the cases with prostate cancer and those with BPH but no prostatitis. We evaluated the relationship between prostatic inflammation and serum PSA levels based on the three-grade pathohistologic criteria for the extent, location and aggressiveness of prostatic inflammation. The serum tPSA levels, fPSA levels, % fPSA, and PSAD were compared among different groups.

RESULTSAs for the extent of inflammation, 35 of the 46 included cases were grade I (tPSA: [8.46 +/- 4.09] microg/L; fPSA: [1.75 +/- 0.93] microg/L; PSAD: 0.15 +/- 0.11), 7 were grade II (tPSA: [15.26 +/- 5.26] microg/L; fPSA: [2.54 +/- 0.72] microg/L; PSAD: 0.26 +/- 0.07) and 4 were grade III (tPSA: [21.05 +/- 7.58] microg/L; fPSA: [3. 19 +/- 1.13] microg/L; PSAD: 0.42 +/- 0.19), with statistically significant differences among the three groups in the levels of tPSA (P = 0.001), fPSA (P = 0.008) and PSAD (P < 0.001). Regarding the location of inflammation, 19 cases were grade I, 17 were grade II and 10 were grade II, with no significant differences in tPSA, fPSA and %fPSA among the three grades (P > 0.05). As for the aggressiveness of inflammation, 32 cases were grade I (tPSA: [8.37 +/- 4.07] microg/L; fPSA: [1.76 +/- 0.93] microg/L; PSAD: 0.14 +/- 0.11), 10 were grade II (tPSA: [13.30 +/- 5.69] microg/L; fPSA: [3.27 +/- 2.21] microg/L ; PSAD: 0.25 +/- 0.06) and 4 were grade III (tPSA: [21.05 +/- 7.58] microg/L; fPSA: [3.19 +/- 1.13] microg/L; PSAD: 0.42 +/- 0.19), with statistically significant differences among the three grades in the levels of tPSA (P = 0.002), fPSA (P = 0.024) and PSAD (P < 0.001). The extent of inflammation was positively correlated with the levels of tPSA (r = 0.6, P < 0.001), fPSA (r = 0.5, P = 0.001) and PSAD (r = 0.6, P < 0.001), and so was the aggressiveness of inflammation (tPSA: r = 0.5, P < 0.001; fPSA: r = 0.4, P = 0.008; PSAD: r = 0.7, P < 0.001), but a negative correlation was found between the aggressiveness of inflammation and %fPSA (r = -0.4, P = 0.013).

CONCLUSIONThe aggressiveness and extent of prostatic inflammation in asymptomatic prostatitis patients are significantly correlated with the level of serum PSA, which may help pathologists to avoid unnecessary repeated biopsies for patients with high-grade prostatitis.

Aged ; Biopsy ; Humans ; Inflammation ; Male ; Prostate ; pathology ; Prostate-Specific Antigen ; blood ; Prostatic Hyperplasia ; blood ; pathology ; Prostatitis ; blood ; pathology ; Serum

OBJECTIVETo investigate the influence of serum storage on the laboratory results of serum T-PSA, F-PSA and FPSA%.

METHODSUsing automated chemiluminescence, we detected and compared the values of serum T-PSA, F-PSA and F-PSA% in the serum stored in different conditions.

RESULTSWhen the serum was stored at 4 degrees C or at the room temperature (22 - 26 degrees C), FPSA was unstable as compared with T-PSA. Compared with the initial value, after 4 hours at the room temperature, F-PSA was decreased to (0.392 +/- 0.246) microg/L (P < 0.01), while T-PSA and F-PSA% to (1.522 +/- 1.085) microg/L and (25.03 +/- 5.94)%, respectively, with no significant difference; after 8 hours at the room temperature, T-PSA and F-PSA were reduced to (1.513 +/- 1.083) and (0.389 +/- 0.247) microg/L (P < 0.05 and P < 0.01). At 4 degrees C, T-PSA, F-PSA and F-PSA% were decreased to (9.418 +/- 7.965) microg/L, (2.168 +/- 1.558) micro/L and (26.6 +/- 6.63)%, respectively, after 2 days (P < 0.05), and to (9.203 +/- 7.736) microg/L, (2.047 +/- 1.478) microg/L and (25.64 +/- 6.56)% after 1 week (P < 0.01). At -40 degrees C, T-PSA, F-PSA and F-PSA% were (4.532 +/- 4.393) microg/L, (1.178 +/- 1.034) microg/L and (24.45 +/- 8.81)% after 4 weeks. When the serum was stored at -40 degrees C and after 3 freeze-thaws, F-PSA and T-PSA were (5.982 +/- 5.314) and (1.341 +/- 1.029) microg/L, respectively, with no significant difference from the initial values.

CONCLUSIONDifferent conditions of serum storage have different influences on the laboratory results of serum TPSA, F-PSA and F-PSA%, more on F-PSA than on T-PSA, while F-PSA% is relatively stable. At -40 degrees C, T-PSA and F-PSA may remain stable for a month at least. Repeated freeze-thaws of the serum do not affect the laboratory results of F-PSA and T-PSA.

Autoanalysis ; Blood Preservation ; methods ; Humans ; Male ; Prostate-Specific Antigen ; blood ; Serum ; Temperature

A review of serum prostate-specific antigen (PSA) values from January 1994 to May 1997 and their correlation with the histopathology of prostate specimens was carried out in the Department of Pathology, Port Moresby General Hospital. The study has shown that this biochemical investigation has not been properly used for the maximum benefit of the patient population. Remedial measures are suggested to improve the sensitivity and specificity of PSA in a setting with limited resources.
Aged ; Humans ; Male ; Middle Aged ; Papua New Guinea ; Prostate-Specific Antigen - blood ; Prostatic Hyperplasia - blood

Humans ; Male ; Prostate-Specific Antigen ; blood ; Prostatectomy ; Prostatic Neoplasms ; blood ; metabolism ; radiotherapy ; surgery

Pro-prostate-specific antigen (proPSA) is the precursor of PSA and a form of free PSA (fPSA). In recent years, a lot of studies have been done on proPSA, the roles of its related indexes in the diagnosis of prostate cancer, and the value of its clinical application. The correlated indexes of proPSA include proPSA, % pPSA, p2PSA, % p2PSA and prostate health index (PHI). They are more effective than total PSA (tPSA) and fPSA in the diagnosis of prostate cancer, especially % p2PSA and PHI, which may significantly increase our ability to detect and identify PCa and lower the rate of unnecessary biopsies. This article presents an overview on the advances in the studies of proPSA and the application of its related indexes in the diagnosis of prostate cancer.
Biopsy ; Enzyme Precursors ; blood ; Humans ; Male ; Prostate-Specific Antigen ; blood ; Prostatic Neoplasms ; diagnosis