Values of prostate specific antigen in patients with operable prostate carcinoma.

Background: Prostate specific antigen (PSA) has significance in diagnostics of the prostate cancer, establishing stage of the disease and follow up of results of the treatment with different methods. Increased PSA levels in serum is not characteristic only for persons who have prostate cancer but also of those with benign conditions, especially in range of 4.0 ng/mL to 10.0 ng/ml, where we see a lot of results superposition. Marker determination of free and total PSA-ratio FPSA/TPSA and total PSA and prostate volume--PSA density was introduced for improvement of the sensitivity of PSA. Purpose is to analyze demonstrators of the concentration of PSA and its fraction in patients with histologically confirmed and radically removed prostate cancer, and to establish its correlation with advancement and differentiation of the disease.

Work Method: The investigation was done in 80 patients with histologically confirmed, prostate cancer clinical stage T1-2, NO, MO, initial PSA level of 2-10 ng/ml and performed radical prostatectomy.

Results: Out of 80 patients, 6 of them (9%) had total serum PSA level within referral values (<4 ng/ml). There were 55 patients (68%) with values of ratio FPSA/TPSA from 0 to 0.15, 18 (23%) patients had values between 0.16-0.19 and 7 (9%) patients had values above 0.20 ratio FPSA/TPSA. Fifty patients (62%) had PSA density in values to 0, 15, and 30 patients (38%) had values above 0.15. According to completed multiple regression analysis values of PSA, ratio FPSA/TPSA and PSA density had no statistically significant correlation with extra-capsular invasion and lymphatic metastasis, which points out that as it is, they do not contribute to its prediction.

Conclusion: Significant number of patients with histologically proven and radically removed prostate cancer had serum PSA level within normal referral values. PSA density and ratio FPSA/TPSA can help in differentiating malignant from benign changes in prostate in PSA values to 10 ng/ml but not with absolute safety since significant number of patients with proven cancer had these parameters in level range characteristic for benign diseases.