Relationship between Prostatic Specific Antigen (PSA) and volume of the prostate in the Benign Prostatic Hyperplasia in the elderly

Abstract

Increase of the Prostatic Specific Antigen (PSA) is a non-invasive, sensitive and specific markers for prostatic diseases, including prostatic cancer. However, age-related Benign Prostatic Hyperplasia (BPH), as well as prostatitis, may at the same time alter PSA values. The aim of this study was to evaluate the relationship between ageing and PSA, and whether age-specific upper normal limits of PSA should be considered for elderly patients. We evaluated 569 consecutive subjects aged 60 years or more (mean age 74.2 years) who were free from malignant prostatic disease, without clinical evidence of prostatic phlogosis and who were not receiving PSA levels affecting drugs. All patients underwent Digital Rectal Examination (DRE) and Trans-Rectal Ultrasonography (TRU), with determination of the three prostatic diameters, the Maximum Adenoma Diameter (MAD) and calculation of the prostatic volume (PV) by the ellipsoid formula. PSA was determined in all patients before DRE and TRU, and the PSA free ratio was determined in those with total PSA values /4 ng/ml. The PSA density was calculated according to the formula PSA/PV. One hundred and seventy-nine subjects (31.6%) were found to have PSA values /4 ng/ml: among them, 26 (14.5%) had values exceeding 10 ng/ml. Age was slightly correlated with PV (P B/0.05), but not with PSA values. On the contrary, PSA values were strongly related with PV and MAD (P B/0.01 both). Mean PSA-free ratio was 16.39/6.0% and most of patients had values in the so-called 'grey zone' of discrimination between benignity and malignity.

Relationship between serum prostate‐specific antigen and prostate volume in Korean men with benign prostatic hyperplasia: a multicentre study

“…There have been numerous reports that the PV can be predicted from the PSA level but most such studies have been of Caucasian men [8–11]. Thus, the difference in PV between Korean and Caucasian men might also result in a different relationship between PV and serum PSA level in Korean men.…”

Foundational Statistical Principles in Medical Research: Sensitivity, Specificity, Positive Predictive Value, and Negative Predictive Value

“…A newer, related parameter, PSA density, is computed as the serum PSA level (in ng/mL) divided by the volume of the prostate gland (in cubic centimeters (cc)). Unlike the PSA test itself, PSA density accounts for the fact that men with larger prostates generally have higher levels of PSA under normal baseline physiologic conditions (i.e., in the absence of prostate cancer) [ 2 ]. Accordingly, consideration of PSA density is increasingly favored over PSA alone for assessing prostate cancer risk [ 3 , 4 , 5 ].…”

Can glycoprofiling be helpful in detecting prostate cancer?

“…Nevertheless, even that PSA testing dramatically improved PCa detection rate, there are also major drawbacks. The first one is a sensitivity of the method, as the width of a grey zone does not give a certain answer to a question if the prostate cancer is present and what is its stage, and the second one is a specificity, since elevated PSA levels can be also caused by prostatitis or BPH (Bo et al , 2003). However, due to widespread PSA testing, the possibility to discover PCa increased while possibility of dying is slightly decreasing (Fig.…”