Difference between revisions of "Prostate-specific antigen"

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[[Image:Prostatelead.jpg|thumb|right|200px|The prostate gland and its surrounding structures. (WC/NCI)]]
[[Image:Advanced prostate carcinoma - PSA - 2 -- very high mag.jpg|thumb|200px|[[Micrograph]] showing a PSA immunostain marking [[prostate carcinoma]].]]
'''Prostate specific antigen''', abbreviated '''PSA''', is marker that is quite [[specificity|specific]] for the prostate.
'''Prostate specific antigen''', abbreviated '''PSA''', is marker that is quite [[specificity|specific]] for the prostate.


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*Increases with age.<ref name=pmid12350489>{{cite journal |author=Ku JH, Ahn JO, Lee CH, ''et al.'' |title=Distribution of serum prostate-specific antigen in healthy Korean men: influence of ethnicity |journal=Urology |volume=60 |issue=3 |pages=475–9 |year=2002 |month=September |pmid=12350489 |doi= |url=}}</ref>
*Increases with age.<ref name=pmid12350489>{{cite journal |author=Ku JH, Ahn JO, Lee CH, ''et al.'' |title=Distribution of serum prostate-specific antigen in healthy Korean men: influence of ethnicity |journal=Urology |volume=60 |issue=3 |pages=475–9 |year=2002 |month=September |pmid=12350489 |doi= |url=}}</ref>


===Prostate specific antigen density===
====Prostate specific antigen density====
:Abbreviated ''PSAD''.
:Abbreviated ''PSAD''.


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*Benign prostate gland versus [[prostate cancer]].<ref name=pmid1371554>{{cite journal |author=Benson MC, Whang IS, Pantuck A, ''et al.'' |title=Prostate specific antigen density: a means of distinguishing benign prostatic hypertrophy and prostate cancer |journal=J. Urol. |volume=147 |issue=3 Pt 2 |pages=815–6 |year=1992 |month=March |pmid=1371554 |doi= |url=}}</ref><ref>{{cite journal |author=Verma A, St Onge J, Dhillon K, Chorneyko A |title=PSA density improves prediction of prostate cancer |journal=Can J Urol |volume=21 |issue=3 |pages=7312–21 |year=2014 |month=June |pmid=24978363 |doi= |url=}}</ref>
*Benign prostate gland versus [[prostate cancer]].<ref name=pmid1371554>{{cite journal |author=Benson MC, Whang IS, Pantuck A, ''et al.'' |title=Prostate specific antigen density: a means of distinguishing benign prostatic hypertrophy and prostate cancer |journal=J. Urol. |volume=147 |issue=3 Pt 2 |pages=815–6 |year=1992 |month=March |pmid=1371554 |doi= |url=}}</ref><ref>{{cite journal |author=Verma A, St Onge J, Dhillon K, Chorneyko A |title=PSA density improves prediction of prostate cancer |journal=Can J Urol |volume=21 |issue=3 |pages=7312–21 |year=2014 |month=June |pmid=24978363 |doi= |url=}}</ref>


====A forumla for PSAD====
=====A forumla for PSAD=====
Benson ''et al.'':<ref name=pmid1371554>{{cite journal |author=Benson MC, Whang IS, Pantuck A, ''et al.'' |title=Prostate specific antigen density: a means of distinguishing benign prostatic hypertrophy and prostate cancer |journal=J. Urol. |volume=147 |issue=3 Pt 2 |pages=815–6 |year=1992 |month=March |pmid=1371554 |doi= |url=}}</ref>
Benson ''et al.'':<ref name=pmid1371554>{{cite journal |author=Benson MC, Whang IS, Pantuck A, ''et al.'' |title=Prostate specific antigen density: a means of distinguishing benign prostatic hypertrophy and prostate cancer |journal=J. Urol. |volume=147 |issue=3 Pt 2 |pages=815–6 |year=1992 |month=March |pmid=1371554 |doi= |url=}}</ref>
:<math>PASD = \frac{serum PSA}{volume}</math>
:<math>PASD = \frac{serum PSA}{volume}</math>
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*The volume of an ellipsoid is:
*The volume of an ellipsoid is:
::<math>\frac{4}{3}\pi D1 \times D1 \times D3</math>.
::<math>\frac{4}{3}\pi D1 \times D1 \times D3</math>.
===Immunostain===
*Specific for prostate.
==Microscopic==
Features:
*Granular cytoplasmic staining.
Notes:
*May be very weak -- need to look at high power.
<gallery>
Image: Advanced prostate carcinoma - PSA -- high mag.jpg | Adv Pca - PSA - high mag. (WC)
Image: Advanced prostate carcinoma - PSA -- very high mag.jpg | Adv Pca - PSA - very high mag. (WC)
Image: Advanced prostate carcinoma - PSA - 2 -- high mag.jpg | Adv Pca - PSA - high mag. (WC)
Image: Advanced prostate carcinoma - PSA - 2 -- very high mag.jpg | Adv Pca - PSA - very high mag. (WC)
</gallery>


==See also==
==See also==

Revision as of 06:35, 2 November 2014

Micrograph showing a PSA immunostain marking prostate carcinoma.

Prostate specific antigen, abbreviated PSA, is marker that is quite specific for the prostate.

General

  • Quantity in the serum used to screen for prostate cancer and follow patients with a history of prostate cancer.
  • PSA immunostain useful for classifying a carcinoma as prostate carcinoma.

Serum PSA

Prostate specific antigen density

Abbreviated PSAD.

Normal is often considered to be: <0.15 ng/ml.

  • Approximately 8% of individuals below the cut-point (0.15 ng/ml) have medium or high-grade cancer.[3]
  • In another series, 48% of individuals with cancer had a PSAD >0.15 ng/ml.[4]
  • Differences between races have been noted in one study; in those without prostate cancer:[1]
    • 0.19 +/- 0.03 ng/ml (blacks).
    • 0.11 +/- 0.01 ng/ml (whites).

PSAD is a better predictor than (unadjusted) serum PSA for:

A forumla for PSAD

Benson et al.:[6]

Where:

.[8]
H, W, L are the height, width and length.

An alternate estimation of the volume is:

.
D1, D2, D3 are the major axes.

Note:

  • The volume of an ellipsoid is:
.

Immunostain

  • Specific for prostate.

Microscopic

Features:

  • Granular cytoplasmic staining.

Notes:

  • May be very weak -- need to look at high power.

See also

References

  1. 1.0 1.1 1.2 Henderson, RJ.; Eastham, JA.; Culkin, DJ.; Kattan, MW.; Whatley, T.; Mata, J.; Venable, D.; Sartor, O. (Jan 1997). "Prostate-specific antigen (PSA) and PSA density: racial differences in men without prostate cancer.". J Natl Cancer Inst 89 (2): 134-8. PMID 8998182.
  2. Ku JH, Ahn JO, Lee CH, et al. (September 2002). "Distribution of serum prostate-specific antigen in healthy Korean men: influence of ethnicity". Urology 60 (3): 475–9. PMID 12350489.
  3. Boulos, MT.; Rifkin, MD.; Ross, J. (Sep 2001). "Should prostate-specific antigen or prostate-specific antigen density be used as the determining factor when deciding which prostates should undergo biopsy during prostate ultrasound.". Ultrasound Q 17 (3): 177-80. PMID 12973074.
  4. Aganovic, D.; Prcic, A.; Kulovac, B.; Hadziosmanovic, O. (2012). "Influence of the prostate volume, prostate specific antigen density and number of biopsy samples on prostate cancer detection.". Med Arh 66 (1): 41-4. PMID 22482342.
  5. Sfoungaristos S, Katafigiotis I, Perimenis P (2013). "The role of PSA density to predict a pathological tumour upgrade between needle biopsy and radical prostatectomy for low risk clinical prostate cancer in the modified Gleason system era". Can Urol Assoc J 7 (11-12): E722–7. doi:10.5489/cuaj.374. PMC 3840515. PMID 24282465. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3840515/.
  6. 6.0 6.1 Benson MC, Whang IS, Pantuck A, et al. (March 1992). "Prostate specific antigen density: a means of distinguishing benign prostatic hypertrophy and prostate cancer". J. Urol. 147 (3 Pt 2): 815–6. PMID 1371554.
  7. Verma A, St Onge J, Dhillon K, Chorneyko A (June 2014). "PSA density improves prediction of prostate cancer". Can J Urol 21 (3): 7312–21. PMID 24978363.
  8. Eri, LM.; Thomassen, H.; Brennhovd, B.; Håheim, LL. (2002). "Accuracy and repeatability of prostate volume measurements by transrectal ultrasound.". Prostate Cancer Prostatic Dis 5 (4): 273-8. doi:10.1038/sj.pcan.4500568. PMID 12627211.