EVALUATION OF AGE-SPECIFIC NORMAL RANGES FOR PROSTATE-SPECIFIC ANTIGEN

Objectives. To compare the traditional normal range (TNR) of 0.0 to 4. 0 ng/mL for serum prostate-specific antigen (PSA) to age-specific norm al ranges (ASNRs). Methods. An autopsy series of completely sectioned, clinically benign prostates from 171 consecutive Caucasian men over t he age of 40 years was selected. These patients were divided into thos e having no prostate cancer at autopsy, prostate cancer less than 1 cc in volume, and prostate cancer at least 1 cc in volume. The PSA value s of each group were compared using both the TNR and the ASNR. Results . Twenty-three of 105 (21.9%) patients with no cancer had elevated PSA values by the TNR, whereas only 18 (17.1%) were elevated using the AS NR. Nine of 54 (16.7%) with cancer less than 1 cc were elevated using the TNR, and 7 of 54 (13.0%,) using the ASNR. Of 12 patients with canc er at least 1 cc, all had elevated PSA levels using the TNR and 11 (91 .7%) were elevated using the ASNR. All discrepancies between the TNR a nd ASNR occurred in the 60- to 79-year age range. Conclusions. Use of ASNRs appears helpful in increasing the specificity of PSA by eliminat ing some elevated values in patients in their 60s and 70s.