Prostate specific antigen (PSA) is produced by prostate cells.
If its indicator exceeds the established norms, then this is a consequence of pathological processes in the gland, therefore, the study of PSA helps to diagnose organ diseases.
The PSA test is the most informative among other tests that detect prostate diseases. With its help, it is possible to determine inflammatory processes in the prostate and benign proliferation of tissue, but the main goal of PSA research is to identify cancer cells.
When a blood test for PSA is prescribed:
- with symptoms characteristic of a malignant tumor in the prostate,
- after the age of fifty, an annual analysis is carried out to determine the PSA norm,
- annual examination after forty years in the presence of relatives with cancer,
- with an enlarged prostate gland,
- to identify the stage of the cancer,
- in order to monitor the progress of treatment.
Until recently, it was believed that the PSA rate was in the range up to 4.0 ng / ml, but medical practice has shown that cancer can also develop at lower rates. Therefore, PSA in excess of 2.5 ng / ml can serve as a sign of malignancy, but only if there are other indirect factors.
The total prostate-specific antigen is equal to the sum of free and bound PSA.
Identification of the total PSA index allows you to:
- diagnose the beginning of the development of pathology,
- examine the prostate for the purpose of prevention,
- detecting PSA norm, evaluate the results of treatment of the prostate gland,
- if a man has undergone surgery, then a general analysis of PSA helps to identify relapses.
Free and Associated PSA:
- free form - PSA is not associated with proteins,
- bound form - PSA bound to alpha 1-antichymotrypsin.
Free PSA in the body of a man is only 10%. Analysis for free antigen allows us to distinguish between benign and malignant formations.
The PSA test is a tumor marker that identifies cancer changes in the prostate, but a high level of antigen may indicate the presence of other diseases of the prostate gland. If elevated PSA is caused by prostatitis or adenoma, then a false positive test is said.
In order to avoid errors in the diagnosis, the doctor uses the PSA coefficient, this allows you to evaluate the ratio of free and associated prostate-specific antigen. If elevated PSA is associated, then cancer is suggested, and if free, benign hyperplasia.
The norm of the dog in the blood in men and deviations from this indicator
The PSA norm in men is considered to be no more than 4.0 ng / ml, if this indicator is exceeded, the patient may be referred for a biopsy, but an elevated PSA is not always a sign of cancer. If a malignant tumor is suspected, additional tests are prescribed to the patient.
Increased PSA in the blood, the norm is more than 4.0 ng / ml:
Exceeding the norm allows us to assume that the prostate gland is under the influence of any processes, internal or external. It rises only when the barrier between the cells of the prostate and the circulatory system is broken.
External effects on the prostate:
- palpation of the gland,
- prostate massage
- Long bike rides
- horse riding,
- violent sex on the eve of analysis,
- placement of a catheter into the bladder,
- body aging (age deviations),
- taking medications to treat benign proliferation of tissue and certain medications.
If there are no such external influences on the prostate, then they talk about pathologies of the gland itself or other internal problems.
The PSA norm in the blood of a man deviates with the following diseases:
- acute prostate
- exacerbation of chronic prostatitis,
- inflammatory diseases of the urinary tract,
- prostate ischemia
- enlarged prostate
- benign hyperplasia
- prostate infarction
- malignant tumor.
Decreased PSA level in the blood, the norm is less than 2.0 ng / ml:
A low PSA index is the norm, this suggests that the risk of developing pathological processes in the gland is minimal. A decrease in prostate-specific antigen indicates the effectiveness of the treatment of prostate diseases.
Interpretation of the result
PSA norm in men characterizes a healthy prostate gland. If PSA is elevated, then the doctor decrypts the indicators, and it is very important to take two tests at once - free and general. It is the ratio of indicators that allows you to diagnose cancer and differentiate it from other pathologies that are symptomatically similar to a malignant formation.
The concentration in the blood of total PSA does not change significantly, an increase in the index may indicate both cancer, prostatitis, and adenoma. With a malignant formation, the level of free PSA is low, and with benign hyperplasia or inflammatory processes in the prostate, it is high. A specialist, interpreting these indicators, can confidently diagnose cancer or exclude such a tumor.
The value of free PSA to the total is determined in the range from 12 to 100 percent. The higher the score, the less likely the risk of cancer.
If the doctor determines the cancer, then conduct additional studies to prescribe adequate treatment.
The traditional treatment for prostate cancer is as follows:
- Remote radiation therapy - The most common cancer control method. It consists in irradiating a diseased organ, the projection of the organ is determined by MRI.
- Brachytherapy - is a type of radiotherapy, which is carried out in the absence of metastases. It is considered the most effective technique to date, the advantage of the operation is that the radiation source is supplied directly to the affected organ, eliminating the harmful effects on other tissues.
- Prostatectomy - Surgery to treat prostate cancer. Such a radical measure is resorted to if other methods are not effective, as a result of the operation, the prostate gland, iliac lymph nodes and seminal vesicles are completely removed.
PSA blood test: normal age for men
To find out the level of PSA, you need to have a blood test. Blood sampling is carried out from a vein in the morning, it is important to take an analysis before 11 o'clock, when the risk of destruction of blood cells in blood serum is minimal.
Before passing the analysis, a number of rules are required:
- during the day before analysis you can’t eat fatty foods,
- on the day of blood donation, nervous and physical stress should be avoided,
- It’s not advisable to smoke at least 30 minutes before blood sampling,
- you can’t take an analysis if less than 10 days have passed since the massage of the prostate,
- to avoid a false positive result, you should not do an analysis if there is inflammation of the urinary tract or after catheterization.
The older the man, the more prostate-specific antigen in the blood, so it is recommended that older people donate blood every year to determine the PSA index. The data are entered in a table, and the doctor can clearly see how the indicators are changing and whether there are reasons for concern.
A blood test for a dog is normal for age (ng / ml):
- up to forty - 1.4-2.5,
- up to fifty - 2.0-2.5,
- up to sixty - 3.1-3.5,
- up to seventy - 4.1-4.5,
- after seventy - 4.4-6.5.
In a woman, the PSA level is 0.2 ng / ml and is not used to detect cancer.
Norms by age, table
Five years ago, a psa of 4 ng / ml was considered normal. Today, psa in adult men should not reach 3 ng / ml. A reference value of up to 4 ng / ml signals the progression of a malignant tumor in the body. It is especially important to control the level of PSA if the patient already has prostatitis. A psa blood test also depends on the age of the patient.
Such a fluctuation of indicators is affected by the size of the prostate, which increases over the years. The synthesis of the agent also increases with age, with free psa growing first, and then there is an increase in the overall coefficient. If this element is absent in the patient, this fact is considered a good sign.
Determining the level of PSA, doctors monitor a blood test in the initial stages of prostate cancer, when the symptoms of the disease are not yet expressed. For the most accurate values, urologists take into account such factors:
- From the age of 50, the prostate enlarges in all men, but a glycoprotein of more than 4 ng / ml in the sixth decade should already cause concern. If in men 65+, a protein coefficient of up to 5 ng / ml is optimal, then in 70 - 80 years old, a figure of up to 6. 5 ng / ml is considered normal.
- Decoding of the analysis: if the total psa is 4 - 10 ng / ml, then the density should not be higher than 15 ng. per ml / cm3. Ultrasound is used to determine this indicator. The density parameter psa allows you to clarify the presence of cancer formation.
- The rate of change is an indicator that displays the aggressiveness of tumor growth. If the result does not exceed 4 ng / ml, then an increase of 0. 75 ng / ml per year is considered critical.
- Interdependence of bound antigen with free psa.
Blood contains 10 - 20% glycoprotein, and 80 - 90% are in psa. This ratio is quite indicative, since a decrease in unbound prostatic antigen is regarded by urologists as the development of a tumor process of the prostate gland. An increase in free psa is a reason for diagnosing prostatic hyperplasia. Such an analysis allows you to clarify the diagnosis.
In older men, an enlarged prostate volume is not an out of the ordinary event, and an elevated psa level only indicates age-related changes. But even for them, a significant increase in psa (10 ng / ml +) is regarded by urologists as a reason for referral for further analysis.
In this video, the doctor will tell you all about the blood test:
Probable causes of deviations
A high level of psa does not always mean the development of a disease. There is a risk of false data when, even at high rates, a man can be healthy. Knowing what the preliminary diagnosis is, you can avoid unreasonable excitement due to excessive PSA. The percentage ratio of the indicator of erroneous results ranges from 6 - 30%. Reasons for false values:
- recent TRUS,
- cycling trips
- prostate massages,
- rectal examination
- the use of certain drugs (Proscar, Avodart) - these medicines reduce the rate of prostatic antigen by 2 times.
Recommendations and comments
Since men's health depends on themselves, in order to diagnose the development of the pathological process in the initial stages, it is necessary to undergo professional examinations annually. Adult men, and especially if they have already been diagnosed with prostate pathology, should receive a psa test every year.
If the indicators are outside the normal range, contact the appropriate medical specialist, and then prepare, undergo a serious examination and pass an empty blood test. Diagnosis of the disease at the primary stage is the key to effective treatment.
Diagnosis of the disease at an early stage allows in almost 100% of cases to recover from a malignant tumor.
What this analysis shows
The abbreviation “PSA” stands for “prostatic specific antigen”. In other words, it is a protein, a type of serine protease that dilutes seminal fluid. Antigen production occurs in the prostate gland.
Depending on the age and general state of health, PSA production in men is carried out in various quantities. Blood levels of antigens indicate how healthy the prostate is.
The study must be carried out for all representatives of the male half of the population who are diagnosed with prostatic hyperplasia, since this disease has the ability to develop into adenoma and cancer.
It is the determination of the PSA level that makes it possible to monitor this process and timely surgical intervention. Only periodic analysis is required. After deciphering the results, the doctor reports the presence or absence of the disease.
PSA is also found in men without any pathological processes, which is considered the norm, since protein synthesis is carried out constantly in small quantities..
The development of prostate cancer can pass without concomitant symptoms. Signs begin to appear at the stage of metastasis, when the tumor is already inoperable.
It is important to diagnose prostate-specific antigen to prevent cancer. It should be noted that the protein structure of PSA is converted into an oncomarker.
An increased level of the indicator may not in all cases indicate the development of oncological processes. In addition, cancer diagnosis is also possible at low values.
Among the main indications for the analysis, there are:
- signs of prostate disease,
- diagnostics to exclude or confirm the formation of a malignant tumor,
- screening for prevention, especially if there is a hereditary predisposition,
- monitoring during the course of therapeutic measures for the treatment of cancer,
- determination of recurrent conditions in patients undergoing surgery.
A blood test for PSA levels is also necessary in the following cases:
- professional activity means harmful working conditions,
- the presence of a tumor in one of the close relatives,
- disorders of the urethra,
- suspected development of prostatitis or benign hyperplasia,
- the presence of blood fluid in seminal or blood fluid,
- history of therapy with hormonal drugs,
- the presence of chronic pain in the pelvic or lower dorsal region.
To exclude overdiagnosis, which significantly complicates the life of a man in the absence of a disease, the analysis is prescribed solely according to indications. In addition, it is important to properly prepare for the study, which implies the exclusion of all factors that may have a negative effect on the prostate.
After a prostatic specific antigen from the prostate is absorbed into the blood, it can be stored in it in 3 types:
- free, while there is no connection with plasma proteins,
- associated with chymotrypsin, which is a highly active plasma enzyme,
- with macroglobulin - combines with blood protein.
These species must be distinguished, as they form the basis of the basic diagnostic test. Thus, the enzyme is classified into:
- free PSA,
- common dog - this is the free parts of the antigen associated with chymotrypsin,
- the ratio of both species.
To determine the quantitative value of the indicator, it is necessary to clarify what type of PSA will be investigated. Most often it is a prostate-specific antigen. In case of exceeding the level, an extended analysis is prescribed, which includes the study of three types of marker for prostatitis.
Norm for men
Normal total PSA values range from 0 to 4 ng / ml.With the development of the pathological process in the prostate, the values will increase.
Each person's body is characterized by individual characteristics.
The prostate in males can also be different. It can vary in size, susceptibility to various factors, as well as resistance to internal and external stimuli.
In addition, it undergoes changes over time, which leads to a natural increase in the indicator.
Standards for age are presented in the table below.
PSA analysis - what is it?
Prostatic specific antigen - this is how the abbreviation PSA is deciphered.
Antigen is a protein substance used to thin the seminal fluid. The enzyme belongs to serine proteases. Antigen is produced in the prostate gland and is one of the components of sperm.
Depending on the general state of health of the man and his age, the prostate gland produces a different amount of PSA. In other words, by the level of antigens in the blood, conclusions can be drawn about how healthy the prostate gland is. For this, a PSA blood test is taken.
In the blood of every man necessarily contains a certain amount of substance penetrating there from the ducts of the prostate gland. Exceeding the normal level of antigens indicates a change in the prostate and a possible disease.
An analysis of the amount of antigens in the blood reveals many ailments of the prostate gland at the earliest, asymptomatic stage. Of particular importance is the early diagnosis of cancer.
Types of Antigen
Most often, for this study, representatives of the stronger sex turn to a problem (or suspicion) of the genitourinary system. Blood sampling for antigen is intended for finding malignant formations of the male prostate gland at an early stage, for diluting ejaculate.
The prostate-specific antigen is partially distributed in the blood, but the bulk penetrates into the seminal fluid. With an increase in the concentration of antigen in the blood or with a change in the proportion of free / total PSA, the patient most likely has a defective protective membrane between the gland cells and blood vessels, which promises several types of diseases.
Photo of the mechanism of PSA in the blood
This antigen in the blood serum is divided into two types: bound (chemical connection of PSA with other substances) and free (antigen in free form).
What is the increase in PSA
You should not draw conclusions in advance about a possible imbalance of the body against the background of an increase in PSA. A PSA blood test is not the only test that determines a prostate tumor!
However, deviations, based on the analysis of PSA, can talk about other transformations of the gland:
- Local inflammatory process,
- Poor blood supply to the prostate
- PSA level changes with age,
- Acquisition of chronic prostatitis,
- Complications of prostatitis
- Prostate cancer.
How analysis and preparation proceeds
On the day, before preparing for the PSA analysis for a man, you should come on an empty stomach and remember the following recommendations:
- cessation of sexual activity 2 days before analysis. The total (free) antigen in venous blood varies with the number of ejaculations,
- analysis on PSA after 72 hours after a comprehensive prostate massage,
- conducting transrectal ultrasound one week before the general blood test for PSA,
- according to the rules of the PSA analysis, a biopsy of the prostate should be done 2 months before the procedure,
- transurethral resection is also performed at least 1 month before the PSA test,
- before the procedure, you need to completely relax (30 minutes before blood sampling),
- exclusion of high fat foods from the diet (the day before the analysis),
- smoking patients should also be prepared before analysis (30 minutes before the procedure for determining PSA, complete cessation of smoking).
Of course, you can go through the blood sampling procedure for PSA, completely neglecting the above rules, however, the result can produce a large error, from which additional problems (which might not have arisen) would arise.
Any procedures related to the insertion of a catheter through the urethra of the penis, cycling, and all actions that may somehow affect the internal organs of the pelvis should be excluded a few weeks before taking blood from a vein to the PSA antigen.
Who is recommended to donate blood
According to statistics, men over 40 years old often have problems with the prostate gland (which often causes malignant tumors). Therefore, during a routine medical examination, such patients are prescribed an additional blood sampling to determine the total and free PSA. However, not only at this age it is recommended to donate blood for PSA.
The circumstances as a result of which the PSA study is prescribed to young people are not very extensive, but significant. Malignant tumors in the prostate area force doctors to prescribe a blood test for this antigen until they reach the age of 40, especially if the symptoms described below are present:
- frequent urination
- the inability to completely empty the bladder,
- pain in the perineum,
- frequent urination in the dark,
- incomplete erection,
- decreased sexual activity.
There is a certain decoding of blood for PSA and, accordingly, deviations in the blood test, according to which the doctor draws conclusions regarding the results of the PSA value:
- PSA norm for men aged 40-49 years - 2.5 units,
- 50-59 years old - 3.5 units
- 60-69 years - 4.5 units
- from 70 years and above - up to 6.5 units.
Clarification: even if, as a result of the analysis for the patient’s total PSA, it exceeds 10 units, this does not mean the presence of a serious illness, since additional blood tests should be performed: for free and general antigen (in addition, if the ratio is below 15%, it is prescribed biopsy).
With modern diagnostics of a blood test for prostate cancer, you can achieve the most reliable result to determine the effective treatment.
Monitoring is carried out on the following grounds:
- After prostatectomy (in the area of the focus of malignancy), a decrease in PSA to 0.2 units. and below
- Tumor irradiation is accompanied by a delayed decrease in antigen levels. If the PSA value reaches 1 unit after the whole complex of procedures, then with a high degree of probability we should expect a long recovery period (remission) of up to 5 years,
- In the worst cases, a relapse of the disease can be expected, which is determined by a sharp increase in the level of prostate-specific antigen after irradiation of the prostate site,
- A prostate tumor gives metastases when the PSA value reaches 50 units, but this value can reach 100 units. The latter means that metastases spread throughout the patient's body.
From all of the above it follows:
The main thing to remember: oncological diseases, and in particular prostate cancer, can be treated, but only if the disease is detected at an early stage. The longer it takes to diagnose the disease (blood sampling on PSA and other studies), the less likely it is to recover.
From all of the above it follows that for an accurate result of a blood test for PSA, a man must comply with all conditions from this material, so that the error in the diagnostic results will be minimized.
Modern medicine is well developed, but not enough to determine the exact diagnosis with a single analysis. A blood test for PSA does not determine a cancer tumor 100% and doctors are well aware of this. Therefore, your treating doctor will prescribe, in case of increased antigen value, additional procedures and tests to detect a cancerous tumor and other “troubles”.
What is PSA analysis
In men, the prostate specific antigen (PSA, PSA) is normally present in the blood. The structure is a glycoprotein that secrete cells of the ducts of the prostate gland. It is needed in order to liquefy ejaculate - this is one of the important factors contributing to the realization of male reproductive function.
Prostate-specific antigen is generally defined as a tumor marker for prostate carcinoma. This indicator is a guideline when choosing the scope of the operation. After the treatment, his assessment indicates the effectiveness of the treatment. Also, its meanings are important in the diagnosis and treatment of prostate adenoma.
- Most PSA is found in the ejaculate. The amount of prostate-specific antigen in the blood is normally very small, due to the histohematological barrier.
- In various situations, PSA in the blood serum grows, which means a violation of the barrier, most often due to tissue growth, inflammation or mechanical stress.
What is general and free PSA?
The antigen is present in the blood as follows:
- PSA free
- Fractions associated with antiproteases:
- 1) alpha 1-antichymotrypsin,
- 2) alpha with 2-macroglobulin. The last fraction is not determined.
The following two values are of clinical importance:
- PSA total (PSA total), including PSA - free, as well as PSA - associated with alpha1-antichymotrypsin),
- PSA Free (f-PSA)
Free PSA / Total PSA Ratio
It is used to identify indications for morphological examination (biopsy) in a specific patient population. A biopsy will be prescribed if the patient’s ratio of free to total PSA is below 15%.
It must be clarified that with a prostate volume of more than 40-60 cm3 this ratio is uninformative.
Deciphering PSA results in a blood test according to age
It is believed that on average, PSA should not be more than 4 nanograms per milliliter. However, this is not a completely correct statement. The interpretation of the analysis takes into account the age of the man, because PSA in the blood will be higher, the larger the volume of the prostate, which increases with age.
An increase in PSA between the ages of 50 and 70 occurs in 15% of cases, and does not always indicate malignant organ damage.
PSA analysis, age norm
Up to 40 years, the upper limit of the indicator is 2.5 ng / ml.
The PSA-free value is normally in the range from 0.04 to 0.5 ng / ml. The above value is usually used to calculate the ratio of PSA fractions.
Additional diagnostic methods
If there are clinical and laboratory indications, morphological verification of the alleged disease is performed. The most effective method was transrectal multifocal puncture biopsy of the prostate under ultrasound control. This is a minimally invasive procedure, the implementation of which is possible without hospitalization in a hospital, on an outpatient basis.
General PSA: its importance in the diagnosis of diseases
In the blood there are:
- total PSA
- free PSA,
- bound PSA.
The sum of bound and free equals the total PSA. The free form normally occupies about 20% of the total PSA.
Diagnostic value is mainly the general level of PSA, the value of which increases depending on the growth of the prostate.
The method is the most specific for identifying prostate cancer. It is prescribed for existing urination disorders, especially at night (nocturia).
It is used in conjunction with finger examination, ultrasound.
Note:determination of the PSA level is prescribed after stimulation of the prostate gland with a finger examination and also after the use of rectal suppositories no earlier than a week after these procedures. Since they can distort a reliable result.
PSA blood test: age norms
An even longer period must be maintained after:
- prostate biopsy techniques,
- removal (resection) of the prostate,
- mechanical massage.
Important:both total and free PSA must be taken and determined from one taken "portion" of blood, use one method. An analysis needs to be done in only one laboratory.
Blood is collected in the morning, before eating. An elbow fold vein is used to collect blood.
Rules for preparing a patient for a blood test for PSA
The last meal should be at least 12 hours before blood sampling. You can drink only ordinary water, no other drinks, especially those containing caffeine, can not be drunk. Alcohol is strictly contraindicated.
Two days before the study, the patient must follow a diet that excludes fried, smoked, fatty, too salty. If possible, you should refrain from meat products. For eating, boiled vegetables, acid-neutral fruits are recommended. You can cook lean vegetable soups and cereals.
For several days, you should refrain from engaging in sports activities, hard physical work, and it is not recommended to ride a bicycle. It is also worth abandoning sexual activity.
Indications for PSA analysis
Men over 45 years old should do a PSA blood test to monitor age-related physiological changes. For preventive purposes, take an analysis once a year.
Every year, check the level of antigen in the blood should also be in the presence of the following indications:
- if someone from close relatives has been diagnosed with cancer,
- if a person works in harmful conditions,
- with suspected prostatitis or benign hyperplasia,
- if hormone therapy was carried out,
- with urination disorder,
- there is blood in the urine or seminal fluid,
- there is chronic pain in the lower back or in the pelvis.
There are two types of blood tests for a substance:
The antigen circulates through the bloodstream in a coherent and free form, in total they allow you to determine the total level of PSA in the blood. Most often, a general PSA is prescribed by the doctor. Free is determined much less often, usually to clarify the diagnosis.
It was found that free antigen is reduced in men in the presence of malignant processes. The likelihood of developing a malignant tumor increases if this substance is detected in an amount of less than 10%. The rate of free PSA should be approximately 15% of the total.
PSA increase rate
The growth rate of antigen over a certain period of time also matters, PSA analysis will also help control this indicator. The rate of increase in antigen is 0.76 nanograms per year.
The fact is that in the presence of cancer cells in the prostate, PSA in the blood can not always be high, so it is important to monitor the level of concentration of substances. If a man had previously taken a PSA test, his norm was 2.5 ng / ml, and after a year the antigen concentration increased to 3.5 ng / ml, this fact cannot be ignored. Over the year, the level increased by more than 0.76 nanograms, which means that an additional examination is required.
When PSA May Be Elevated
An increase in PSA levels cannot unambiguously indicate the presence of malignant processes. A high level of antigen may indicate diseases and inflammatory processes, such as:
- inflammation of the prostate
- ischemia or prostate infarction,
- chronic prostatitis
- urinary tract infection.
Also, the level of antigens in the blood is affected by: recent ejaculation, massage and diagnostic prostate palpation.
Various medical and hormonal drugs also affect the concentration of a substance in the blood.
If the antigen level is high enough, for a more accurate diagnosis, the doctor prescribes a re-analysis or biopsy of the prostate.
To diagnose a cancerous tumor, analyzing the amount of antigens alone is not enough.To confirm the diagnosis, a number of additional comprehensive studies, for example, a biopsy, will be required. However, it is a blood test for general PSA that indicates the first signs of prostate cancer, usually without pronounced symptoms.
Basically, a PSA blood test is used as a tumor marker, but there are other situations where controlling the level of antigens can be useful.
If prostate cancer is not in doubt, the analysis will help determine how the disease has progressed, to keep under control the course of treatment and its effectiveness. To compare the results, the analysis is repeated every three months.
After surgery to remove cancer in the prostate and postoperative therapy, the PSA level should normalize. If this does not happen, then a relapse has occurred, and the disease is progressing again.
The problem of a malignant tumor in the prostate is more relevant than ever, as the increase in morbidity and mortality is steadily increasing. A PSA blood test will help determine the disease at an early stage when the disease is best treated. The whole procedure will cost you about 500 rubles.
Analysis of total prostatic specific antigen (PSA)
Total PSA is a tissue prostatic protein that is part of the excretory secreted prostate. In medicine, it is a marker of tumor diseases.
In which cases an analysis is prescribed to determine the total PSA values:
- diagnosis of prostate adenoma,
- control of adenoma treatment,
- diagnosis of prostate cancer, especially early detection of a tumor,
- monitoring the treatment process of an already diagnosed malignant neoplasm of the prostate gland.
Normally, the content of total PSA in the blood ranges from 0-4 ng / ml. But there are different opinions about the norms. Recently, a number of researchers have limited the norm to 2 ng / ml.
In what cases are increased indicators of total PSA determined:
- at all stages of development of prostate adenoma,
- after surgery for removal of prostate adenoma,
- after the fact of an ejaculation that happened on the eve of the analysis,
- in case of potency problems,
- with various forms of violation of the act of urination,
- after a long bike ride, especially on a shaking road.
Note:if the PSA (total) values exceed 30 ng / ml, then this fact should be regarded as a case of a possible developing oncological process.
In advanced stages of cancer, with existing metastasis, total PSA values can reach 1000 ng / ml and higher.
Analysis of the free prostatic specific antigen PSA
Free prostatic specific antigen forms part of the total PSA and is also a product of the physiological activity of the prostate gland.
Note:the larger the age, the higher the rate of this antigen.
In any case, its level should not go beyond 4 ng / ml.
Data from this marker must be determined for signs of prostate cancer.
In addition to the free PSA indicator itself, in urological andrological practice, the determination of the percentage of free PSA to total PSA is also used. The value is determined in percentage terms.
The numbers of this ratio become especially important if the total PSA is already above the norm, but does not rise to critically dangerous values and is in the range of 4.0-10.0 ng / ml.
In this case, if the ratio of free PSA / total PSA does not rise above 15%, one can assume the presence of benign growth. If in the process of dynamic monitoring the level of this indicator is gradually increasing, then conclusions can be drawn about the possible malignancy of the process, as well as the small effect of both conservative and surgical measures.
If, against the background of the treatment, the level of ratio decreases, then we can draw conclusions about the beneficial effects of the treatment process.
A normal PSA score of less than 0.93 ng / ml.
Indications for free PSA:
- dynamic monitoring and control of patients with established malignant prostate cancer,
- dynamic monitoring and monitoring of patients with a diagnosis of “prostate adenoma” with the main goal of early diagnosis of a possible malignancy of the process,
- differential diagnosis of cancer, adenoma and prostatitis,
- as a preventive analysis in men over the age of 50.
In which cases the concentration of free PSA is increased:
- with existing prostate adenoma at different stages of the disease,
- inflammatory and proliferative processes of prostate tissue (prostatitis),
- malignant pathology of the prostate gland,
- early postoperative period in surgical treatment of the pancreas,
- ejaculation (ejaculation) a few hours before the test.
With prostate cancer, the level of free PSA is much lower than with benign hyperplastic processes and inflammatory diseases.
The prognostic value is the ratio "PSA free / PSA total":
- if the indicator is less than 15% - then it speaks of serious problems that are present, and is prognostically unfavorable,
- if the indicator is in the range of 15-70%, then the forecast is favorable.
General recommendations and comments
The state of health in most cases depends on the person himself. To determine the developing malignant process in the early stages, it is necessary to periodically undergo preventive examinations.
That is why men, after reaching the age of 50, and in some cases even earlier (with already existing prostate pathology), must take an analysis of PSA at least once a year.
If you find analysis indicators that go beyond the norm, you should see an andrologist, urologist, or oncologist, and undergo a full examination with the aim of early diagnosis of a possible disease.
Note:not in all cases when the numbers of the analysis go beyond the norms there is a pathological process.
The detection of a malignant disease in the early stage makes it possible to recover from it in almost 100% of cases.
You will receive more detailed information about the blood test procedure for PSA and other tumor markers, as well as the effectiveness of these tests, by watching the video review:
Lotin Alexander, medical observer
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