The effect of high grade prostatic intraepithelial neoplasia on serum total and percentage of free prostate specific antigen levels

Citation
Cg. Ramos et al., The effect of high grade prostatic intraepithelial neoplasia on serum total and percentage of free prostate specific antigen levels, J UROL, 162(5), 1999, pp. 1587-1590
Citations number
21
Categorie Soggetti
Urology & Nephrology","da verificare
Journal title
JOURNAL OF UROLOGY
ISSN journal
00225347 → ACNP
Volume
162
Issue
5
Year of publication
1999
Pages
1587 - 1590
Database
ISI
SICI code
0022-5347(199911)162:5<1587:TEOHGP>2.0.ZU;2-C
Abstract
Purpose: It is established that the percentage of free prostate specific an tigen (PSA) in serum is low in patients with prostate cancer. An unanswered question is whether a low percentage of free PSA can be explained by high grade prostatic intraepithelial neoplasia alone. We compared the percentage of free PSA in men with high grade prostatic intraepithelial neoplasia alo ne, prostate cancer, benign prostatic hyperplasia (BPH) and a normal prosta te (that is normal digital rectal examination and PSA less than or equal to 2.5 ng./ml.). Materials and Methods: From October 1994 through December 1997, 48 men were diagnosed with high grade prostatic intraepithelial neoplasia without conc omitant prostate cancer. Of these men 43 with a mean age plus or minus stan dard deviation of 67.4 +/- 7.8 years comprised our study group. To date non e has been diagnosed with cancer during followup. Serum free and total PSA levels were measured, and the percentage of free SA was calculated. The per centage of free PSA in the 43 men was compared to that in 50 with prostate cancer (mean age 65.4 +/- 7.8 years), 50 with biopsy proved BPH (67 +/- 7) and 43 with a normal prostate (61 +/- 8). Results: There was no significant difference in mean total serum PSA in pat ients with high grade prostatic intraepithelial neoplasia, prostate cancer or BPH. The percentage of free PSA was significantly lower in patients with prostate cancer (14.9 +/- 6.5%) than those with high grade prostatic intra epithelial neoplasia (20.8 +/- 7.1%), BPH (20.1 +/- 7.3%) or a normal prost ate (27.7 +/- 12.2%). There was also no significant difference in the perce ntage of free PSA between men with high grade prostatic intraepithelial neo plasia (20.8 +/- 7.1%) and those with BPH (20.1 +/- 7.3%). Additionally, me n with a normal prostate had a higher percentage of free PSA (27.7%) than t hose with BPH (20.1%), high grade prostatic intraepithelial neoplasia (20.8 %) or prostate cancer (14.9%). Conclusions: The percentages of free PSA in men with high grade prostatic i ntraepithelial neoplasia and BPH are similar, and significantly higher than those found in men with prostate cancer.