SERUM PROSTATE-SPECIFIC ANTIGEN LEVELS IN STAGE-A1 PROSTATIC-CANCER

Quantitation of serum prostate-specific antigen (PSA) has recently com e into widespread use. Controversy exists regarding its usage in scree ning for carcinoma of the prostate (CAP), based partly on concern that it may detect small foci of CAP that will not cause any significant m orbidity or mortality. This study was conducted to evaluate serum PSA levels in stage A1 CAP. The authors identified 143 consecutive men who had PSA levels drawn within 8 weeks of transurethral resection perfor med for presumed benign prostatic hyperplasia. One hundred twenty-four of these (86.7%) had no cancer, 11 (7.7%) were found to have stage A1 CAP, and eight (5.6%) were found to have CAP beyond stage A1. The mea n PSA level in patients with stage Al CAP was 2.3 ng/mL, and the benig n (no cancer) group had a mean PSA level of 3.8 ng/mL. Ten of the 11 p atients in the stage A1 group had PSA values less than 4.0 ng/mL. Ther efore, it was found that most patients with stage Al CAP did not have elevated PSA levels. In the authors' experience, elevation of PSA leve ls caused by CAP is indicative of a tumor burden greater than that fou nd in stage A1 CAP.