26736 May 13
IMPORTANT!
The information in this section cannot be used for self-diagnosis and self-treatment.
In case of pain or other exacerbation of the disease, diagnostic tests should be prescribed only by the attending physician. To make a diagnosis and properly prescribe treatment, you should contact your doctor. We remind you that independent interpretation of the results is unacceptable, the information below is for reference only
General PSA (general prostate specific antigen): indications for use, rules for preparing for the test, interpretation of results and normal indicators.
High PSA level
An increase in the level of PSA , prostate-specific antigen, or prostate-specific antigen in the blood does not always indicate the presence of a malignant oncological process. But it must be remembered that isolated BPH (prostate adenoma, benign prostatic hyperplasia) is rarely accompanied by an increase in PSA levels. Very often, BPH and prostate cancer are accompanied by chronic prostatitis. The combination of BPH and chronic prostatitis, according to Sarklinik, is observed in 57%, and the combination of prostate cancer and chronic prostatitis is observed in 83%.
PSA AS A METHOD FOR DIAGNOSIS OF PROSTATE CANCER
25.Feb.2020
Prostate cancer
- an extremely insidious disease. The danger lies in the fact that in the early stages of development, the disease rarely shows itself as symptoms, or the severity is so low that patients often simply do not pay attention to them, counting on self-resolution of the problems
The increase in prostate cancer can be explained by low diagnostics (more typical for peripheral areas) and medical “illiteracy” of patients, or a common negligent attitude towards their health.
However, prevention is simple to the point of banality and consists of organizing an annual examination of men by a urologist, performing an ultrasound of the prostate gland (as the gold standard for diagnosis, TRUS - transrectal ultrasound) and PSA. And today we will focus our attention on the last of the listed diagnostic methods. By the way, the discovery of PSA as a method for diagnosing prostate cancer has sharply reduced the number of advanced cases of cancer.
What is PSA?
Prostate-specific antigen (PSA) is a marker that is detected in blood plasma and is used to diagnose and monitor the course of prostate cancer (PCa) and benign prostatic hyperplasia (BPH). PSA is a complex polypeptide produced by the epithelial cells of the prostate gland, most of which enters the seminal fluid, and only a small part of which enters the blood serum. PSA, in turn, enters the bloodstream and binds to proteins. Part remains in an unbound form, such PSA is called free. More often in urological practice, the level of total PSA is used. In controversial situations, a more detailed analysis is used, which is called the PSA ratio; normally more than 15%. What is the level of PSA in the blood? Normal PSA levels range from 0 to 4 ng/ml. Also, the PSA level is different for each age group. So, for example, for men aged 40-49 years the norm is from 0-2.5 ng/ml; from 50 to 59 years old - 0-3.5 ng/ml; from 60 to 69 years old - 0-4.5 ng/ml, from 70 to 79 years old - 0-6.5 ng/ml.
What to do
, if your PSA test is higher than normal? When PSA levels are up to 10 ng/ml, this is the so-called “gray zone”. The gray zone does not confirm that the patient has prostate cancer, but at the same time it does not exclude oncology. This PSA level obliges the attending physician to begin a more in-depth examination, in particular a rectal digital examination, as well as TRUS. If necessary, resort to prostate biopsy. The patient must be reassured and the need for further examination and treatment explained. A total PSA of more than 20-30 ng/ml, with a ratio of total PSA to free PSA of less than 10-15%, with a 95% probability indicates an oncological process in the prostate.
Does any increase in PSA necessarily mean prostate cancer? NO. PSA is not a specific tumor marker, but is an organ-specific marker, i.e. An increase in PSA can be caused not only by oncology, but by other diseases and conditions associated with the prostate gland: chronic prostatitis, testing earlier than 3-4 days after a rectal examination or sexual intercourse, constipation. An increase in PSA is also observed in patients who independently perform physical procedures at home. How to take a PSA test correctly? The rules are simple. Firstly, 4-5 days before the test, no manipulation of the prostate gland. Secondly, avoid sexual intercourse. If the patient has been under observation for a long time by a urologist for prostate adenoma and is taking medications from the 5-a reductase inhibitor group (finast, finasteride, penester, avodart, etc.), one month before the expected PSA test, it is necessary to stop taking these medications.
Preventing prostate cancer is simple. At the first symptoms of urinary disorders (frequent urge to urinate, feeling of incomplete emptying of the bladder, difficulty urinating), you should consult a specialist. Starting from the age of 45 - even if the listed symptoms do not bother you - a man is required to undergo an examination by a urologist annually for the purpose of early detection of prostate cancer (screening). Prevention of prostate cancer also includes a healthy lifestyle (giving up tobacco, alcohol, running, cycling), diet (the diet should include tomatoes, pumpkin seeds, fresh vegetables and fruits), and regular sex life.
Murtazali Kuramagomedov, urologist, Nyagan City Clinic
Norms for the range of total PSA levels taking into account the patient’s age, PSA general norm
It is necessary to take into account a wider range of total PSA levels based on the patient's age. This makes it possible to detect prostate cancer at the earliest stages, and on the other hand, there is no need for an invasive test - a biopsy of the prostate gland (prostate). At the age of up to 35 years, the normal value of total PSA level is no more than 1.55 ng/ml, from 36 to 45 years, no more than 1.95 ng/ml, from 46 to 55 years, no more than 3.2 ng/ml, from 56 years up to 65 years no more than 5.5 ng/ml .
Preparing for analysis
The procedure is carried out strictly on an empty stomach, but is not tied to a specific time of day. A PSA test can be taken in both public and private clinics. The reliability of the result largely depends on the patient’s preparation. The day before the procedure is necessary.
- Avoid everything fried, salted and smoked. Such food provokes the active production of substances similar to tumor markers.
- Eliminate physical and emotional stress. A stressful situation can radically change the functioning of the enzymatic system. You can't ride a bicycle.
- Do not smoke at least one hour before blood collection. Don't drink alcohol for at least a day.
- Medication intake is limited for two days. If this is not possible, be sure to notify the doctor about the names of the drugs.
- Avoid sexual intercourse for two days before the test.
- It is important that before the procedure at least 10 days have passed since the last prostate massage. After prostate surgery, PSA is taken no earlier than six months later.
In the referral for analysis, if necessary, indicate the presence of a confirmed diagnosis of prostate cancer, as well as information about previously performed medical procedures.
The study is carried out in a complete ELISA laboratory, which has a shaker-incubator, a washing device and a microplate photometer. Kits for PSA determination are produced by a number of Russian and foreign manufacturers. At the same time, domestic devices are not inferior to imported analogues in terms of accuracy. In terms of cost of analysis, they are many times more economical.
Dynamics of changes in total PSA levels over time, PSA V
An important criterion for assessing the pathological process is the dynamics of changes in the level of total PSA over time. This indicator is called PSA V. The increase in PSA levels in prostate cancer occurs at a much faster rate than in BPH (prostate adenoma) or chronic prostatitis. Sarklinik in Saratov believes that the limit for the annual increase in PSA levels over 1 year should be no more than 0.67 ng/ml . That is, the increase in PSA in one year should be a maximum of up to 0.67 ng/ml, compared to the previous year. Over 6 months (if PSA is performed once every 6 months), the increase in PSA level should be no more than 0.33 ng/ml .
Dear patients, if you want to receive detailed information on the following issues, please contact us for a personal consultation in Saratov: what is a tumor marker analysis of a dog, where is a dog’s blood test performed and its decoding , what is the norm, how is the test carried out, where can a dog’s blood test be done and passed, when to get the results, how to prepare for the dog test , what is its cost and price, how to deal with impotence , how to treat early ejaculation? The PSA blood test is a highly informative screening test!
If you are undergoing a routine examination and you are over 45 years old, then take: total PSA, free PSA, prostate health index .
Photo: Rob3000 | Dreamstime.com\Dreamstock.ru
If you have any questions related to PSA, total PSA, free PSA, prostate specific antigen, what is multiparametric MRI of the prostate (mpMRI), PIRADS (Prostate Imaging Reporting and Data System), ask your doctor on the website sarclinic.ru!
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Comments ()
Free PSA test
Free antigen is the active form that is not bound to blocking molecules. Some of the PSA protein that enters the blood binds to other proteins, the level of which can be measured. Prostate cancer cells (unlike soft tissue) no longer produce PSA. Therefore, in this situation, the percentage of free PSA is minimal.
Free PSA is a marker that has tissue specificity, not just cancer. The analysis is significant for screening examinations of large groups of patients. This is a safe and economical method.
To analyze total and free PSA, serum without foreign particles is used. The material can be stored at temperatures from +2 to +8° C for 24 hours. For longer storage (up to three months), the blood must be aliquoted and frozen. Secondary freezing and thawing should be avoided. After thawing, the samples are thoroughly mixed.
The biomaterial is placed in sealed tubes and sent for examination. Coagulation factors are first removed from the blood taken. Enzyme-labeled antibodies are then injected into the serum. They interact with free PSA and form a specific complex. The second step is the addition of a chemiluminescent substrate. A non-thermal glow is released, the intensity of which is recorded. The entire study takes a maximum of a few hours.
PSA and oncology
What the PSA tumor marker shows is interpreted by the doctor in each specific case. According to medical statistics, almost 80% of cases of cancer changes in the prostate gland are accompanied by an increase in this protein. However, its high values may indicate other pathologies, so do not worry in advance. To clarify the diagnosis and exclude oncological degeneration, the doctor will prescribe a transrectal biopsy of the prostate under ultrasound guidance. Histological examination will reliably show whether there are changes in the tissues of the gland.
An increase in PSA is a reason to seek help. Experienced urologists and andrologists at the Dr. AkNer will help to identify pathology in a timely manner and prescribe adequate therapy.
Urologist, andrologist Akopyan Nerses Grigorievich.
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Why is this informative?
The medical definition of PSA indicates that normally the bulk of this protein substance is located in the ducts of the gland. Its task is to provide the desired consistency of the seminal fluid and promote its liquefaction. In healthy men, a small portion of the protein passes from the ductal system into the blood vessels and then into the blood. It is this parameter that is monitored during screening.
An increase in the indicator occurs in response to certain changes in the body. With the development of pathology, the barrier between the blood vessels and the ducts of the gland is broken, which causes massive penetration of protein into the blood.
Specific protein
This is a substance that is produced exclusively by prostate tissue. Determined if organic lesions of the prostate are suspected - benign or malignant. An increase in PSA is observed during:
- prostatitis;
- infectious organ lesions;
- hyperplasia;
- malignant neoplasm.
According to statistics, among patients whose PSA value is in the range of 4-10 ng/ml, the biopsy detected malignant cells in only 25%.
The ratio of free to total PSA in prostate adenoma is usually higher than in cancer. But to confirm any of the diagnoses, additional diagnostic methods are needed.
