Benign prostatic hyperplasia prostate-specific antigen

Prostate-specific antigen (PSA) is one of the most reliable cancer-specific molecular markers. PSA expression is, for the most part, restricted to the prostate and elevated serum PSA indicates the possibility of malignant prostate cancer. Use of serum PSA as a diagnostic tool is still controversial since PSA levels are also elevated in benign prostatic hyperplasia (BPH),... 

Prostate Volume and Serum Prostate-Specific Antigen Predictors of Responsiveness to 5a-Reductase Inhibitors in Men with Benign Prostatic Hyperplasia... 

Figufe 15-1 Prostate-specific antigen (PSA) levels for patients with benign prostatic hyperplasia (BPH) and known prostatic carcinoma (CA) are shown with two decision-level cutoffs. Tests A and B in Table 15-4 were actually the same test with two different cutoffs. 

Figure S-3 Receiver operating characteristic curves of prostatic acid phosphatase (PAP) and prostate-specific antigen (PSA) assays for patients with benign prostatic hyperplasia and prostatic carcinoma. Because the PSA assay curve is above the PAP assay curve at ail points, the PSA assay is the better assay for the patients tested.

Mikolajczyk SD, Miller LS, Wang TJ, et al. BPSA a specific molecular form of free prostate specific antigen is found predominantly in the transition zone of patients with nodular benign prostatic hyperplasia. Urology 2000 5 41-5. 

Roehrborn CG, McConnell J, Bonilla J, et al. Serum prostate specific antigen is a strong predictor of future prostate growth in men with benign prostatic hyperplasia—Proscar long term efficacy and safety study. J Urol 2000 163 13-20. 

Pannek J, Marks LS, Pearson JD, et al. Influence of finasteride on free and total serum prostate specific antigen levels in men with benign prostatic hyperplasia. J Urol 1998 159 449 53. 

Pharmacology In vitro studies have shown inhibition of 5a-reductase and antagonistic effects at androgen receptors. Clinical trials of saw palmetto in benign prostatic hyperplasia (BPH) have shown improvement in urologic function and in urinary flow. When compared with finasteride in BPH, saw palmetto did not lower prostate-specific antigen or dihydrotestosterone levels. However, sexual dysfunction was less with saw palmetto than with finasteride. Clinical improvement of BPH with saw palmetto appears to be less than that with alpha-blockers. 

In a study on the safety of 320 mg saw palmetto daily for 1 year in men with benign prostatic hyperplasia, no significant differences in serious or nonserious adverse events were reported between the saw palmetto and placebo groups. No clinically significant differences in sexual functioning, bilirubin levels, urine tests, or prostate-specific antigen levels were observed between the saw palmetto and placebo groups (Avins et al. 2008). 

Prostate cancer is the most common cancer form in males in the USA and Western Europe. One of the methods to diagnose prostate cancer is to measure the prostate-specific antigen (PSA) which leaks into the bloodstream from the prostate. In cancer patients the cells in the prostate are growing unrestrained and become more unstructured which leads to an increased leakage of PSA into the blood. But only 25 % of men with elevated PSA levels have prostate cancer, while the remaining patients have, for example, benign prostatic hyperplasia (BPH) or a temporary infection. This makes it important to develop improved and more differentiated PSA assays to enable discrimination of patients with malignant disease. 

Edinger MS, Koff WJ (2006) Effect of the consumption of tomato paste on plasma prostate specific antigen levels in patients with benign prostate hyperplasia. Braz J Med Biol Res 39 1115-1119... 

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