SERUM-FREE AND TOTAL PROSTATE-SPECIFIC ANTIGEN LEVELS IN PATIENTS WITH LIVER-DISEASE

Objectives. To determine the effect of liver diseases on serum free pr ostate-specific antigen (fPSA) levels, total prostate-specific antigen (tPSA) levels, and fPSA/tPSA ratios. Methods. Serum concentrations of tPSA and fPSA were measured in 18 men with histologically confirmed l iver cirrhosis, 20 men with histologically proved chronic hepatitis, a nd 20 healthy men. All patients underwent a standard urologic evaluati on, including history, physical examination, urine analysis, serum fPS A and tPSA determinations, and liver function tests (serum bilirubin, serum glutamic oxaloacetic transaminase, and serum glutamic pyruvic tr ansaminase). Results. Patients with liver cirrhosis had slightly lower fPSA levels than did control subjects or patients with chronic hepati tis, but these differences did not reach statistical significance. tPS A levels also were not significantly different among the three groups. Conclusions. In the presence of liver disease, despite the limited li ver reserve, tPSA and fPSA are specific and reliable markers in the cl inical management of prostatic diseases in this population. This resul t should be taken into account when serum concentrations of fPSA, tPSA , and the fPSA/tPSA ratio are evaluated in patients with liver disease . (C) 1998, Elsevier Science Inc. All rights reserved.