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What is a prostate tumor marker

Prostate cancer marker test

The term canine tumor marker in clinical terminology stands for prostate antigen. A protein antigen is a high molecular weight protein that is produced by the glandular cells of the prostate. A change in the quantitative indicator of this protein indicates that any pathological changes develop in the tissues of the prostate gland, this leads to a violation of its secretory function. As a rule, an analysis for the determination of psa is carried out in order to diagnose oncological diseases of benign or malignant origin.

What is the purpose of this laboratory analysis?

An analysis for the determination of a specific antigen in clinical practice is carried out in order to detect pathology in the glandular tissue of the prostate.

The main reasons for conducting this laboratory study are:

Blood test

• pathological formations in the tissues of the prostate of an oncological nature;
• inflammation of tissues by bacterial pathogens;
• replacement of glandular cells of the prostate with connective tissue layers;
• acute tissue ischemia due to obliteration of the arteries supplying the gland;
• monitoring the effectiveness of therapeutic measures for various diseases.

An analysis for the determination of a tumor marker in the study of the prostate gland is carried out in the form of a venous blood sampling. The study is appointed by the attending doctor, and blood sampling is carried out in specialized manipulation rooms. Before the procedure, men must be prepared, this is necessary to obtain better results.

Events carried out to prepare for the analysis

Before taking the test, you should follow the general rules of preparation, otherwise the doctor will receive incorrect results, which will mislead him.

Basic rules for preparing for the study:

We follow the rules before passing the analysis

All of the above rules are mandatory if the patient is interested in conducting high-quality diagnostics. If any rules have been violated, the patient must report this to his doctor.

Analysis tactics

An analysis for the determination of an oncological marker is carried out in the morning, this condition is mandatory. Peripheral blood sampling should continue no later than 11 o'clock in the afternoon. To obtain the test material, blood is drawn from a vein with a 20 milliliter syringe; before donating blood, it is absolutely forbidden to eat food and even water.

The blood is placed in a specially prepared test tube, which is hermetically sealed or contains a special gel to preserve the blood. After that, the nurse takes the material to a specific laboratory.

Transcript of the results of the study, normal indicators

After receiving the results of a laboratory test, the treating doctor makes his conclusions that the concentration of the protein antigen is normal or that there are any deviations. Based on the results obtained, the final diagnosis is established and it is decided whether it is necessary to carry out therapeutic measures. Normal prostate antigen levels range from 0.2 - 4 ng / ml.

You should take into account the fact that normal indicators may change depending on age-related changes:

Explanation of indicators

• 40 - 49 years old, the norm is 2.5 ng / ml;
• 50-59 years normal 3.5 ng/ml;
• 60-69 years normal 4.5 ng/ml;
• 70-79 years, the norm is 6.5 ng / ml.

As the above statistical indicators show, the results of the study and their standards may vary for each person, depending on age characteristics.

Evaluation of the results of the study, negative results

Elevated canine tumor markers show the overall risk of developing an oncological process in the prostate gland, only a qualified specialist can evaluate the result of the analysis.

With an increase in the concentration of prostatic antigen in the peripheral blood, the doctor assessing the indicators immediately suspects an oncological pathology of the prostate gland. Comparing the statistical indicators of 30% in patients with an increase in normal antigen values, tumors of benign etiology are detected, this condition is quite successfully treatable and has a low percentage of relapses. The remaining 70% suffer from a malignant form of oncological pathology, and unfortunately the prognosis for a full recovery is not favorable.

A slight increase in the antigen in the blood indicates the initial stage of the disease, as a differential diagnosis, the doctor conducts additional instrumental diagnostics and prescribes treatment. Exceeding more than 20 ng / ml indicates a long-term course of the oncological process, an increase of more than 40 ng / ml indicates the progression of the disease with severe metastasis to nearby organs and lymph nodes.

How accurate is the analysis?

A laboratory test for the quantitative content of the prostate protein antigen in the blood may not show reliable results in all cases. About 10% of cases were registered when the negative results of the study were erroneous and showed normal results, but at the same time, cancer progressed in the human body. Such errors are most often found in connection with the individual peculiarity of hemodynamics and reduced permeability of the walls of blood vessels. In other cases, the determination of a prostatic tumor marker is the most reliable method for diagnosing prostate cancer.

Prostate tumor marker norm in men

Prostate - the prostate gland is an organ of the male reproductive system. It is involved in the production of seminal fluid and in the process of urination. Organ pathologies lead to impotence and infertility. Every third man over 30 years of age meets with certain diseases of the prostate gland. And every seventh over 50 - with Prostate cancer. The disease is difficult to cure, so timely diagnosis is very important. The main way to detect a tumor at an early stage is an analysis for PSA (PSA) - a specific prostate antigen - a quantitative increase in which in the blood serum is the first bell and an indication for a deeper diagnosis by hardware methods.

Features of prostate cancer and PSA

Prostate cancer is the second most common cancer affecting males. The disease is amenable to surgical and medical treatment, but despite this, it has a high mortality rate. A number of factors contribute to this:

• The tumor develops slowly, over several years;
• no overt clinical symptoms until the lesion reaches a certain size;
• date early multiple metastases;
• is not determined visually and by ultrasound.

The ultrasound machine will only show that there are inflammations and modifications of the organ, but does not state the presence of a tumor. A more accurate diagnosis will be shown by a biopsy or fluoroscopy, which, for preventive purposes, does more harm to the body than good.

However, like other types of tumors, prostate carcinoma has its own tumor markers - certain signs, the change of which indicates a pathological process. With prostate carcinoma, this is PSA.

Prostate specific antigen is a glycosylated protein produced by the surface cells of the organ. Its main purpose is to thin the seminal fluid. In addition to sperm, the substance is part of the blood serum, where it binds to other proteins (bound PSA) or exists unchanged (free PSA). The analysis, called PSA total, shows the total amount of antigen in 1 ml of the material.

Even a small tumor in the initial stage increases the production of a substance, and this makes it possible to detect cancer at an early stage. The amount of antigen that exceeds the permissible norm does not indicate the presence of carcinoma, but is a direct indication for deep diagnosis. The value within the age norm by 99% confirms the health of a man.

Indications for analysis

Blood sampling to determine the total amount of PSA is carried out in any clinical laboratory in the direction of a urologist or oncologist. The reason for the analysis can be both a routine check and the presence of signs of prostate disease.

In order to prevent tumor formations of the prostate, it is recommended to donate blood for PSA to men over 35 years old - once a year, over 50 years old - once every six months.

Direct indications for analysis:

• there are signs of diseases of the genitourinary system (difficulty/frequent urination, pain, discharge, decreased potency and erectile function);
• change in the size of the prostate, revealed during the examination;
• the presence of a tumor in blood relatives;
• monitoring the effectiveness of the treatment of diagnosed prostate adenoma or carcinoma.

Blood for analysis is taken from a vein. The procedure is quick and almost painless, does not require hospitalization and issuance of a disability certificate.

Preparing for the procedure

For more accurate readings and the elimination of false positive results, patient preparation is required:

It is advisable to refuse to eat 3 hours before blood sampling, if this is not possible - the snack should be light, low-fat.

The antigen produced by the prostate is present in the blood serum even against the background of a man's complete health. It is known that with age, the size of the prostate gland increases, in connection with this, the level of protein also increases.

So, the quantitative norm of total PSA up to 40 years is the value - 1.4 ng / ml, and after 70 - 6.5 ng / ml. The level of 4 ng / ml is considered the average indicator of the norm, but it should be remembered that such a value in a young man can be a sign of pathology.

An increase in the level of total PSA to 10 ng / ml serves as a signal for a detailed diagnosis, in more than 50% of cases the change is caused by an oncological process.

Transcript of results

Even with an increase in the antigen level to 3-4 ng / ml, additional diagnostics are required, such as ultrasound or X-ray.

A level of 4 to 10 ng / ml indicates the presence of a neoplasm, an additional examination of the patient will show whether the tumor is benign (adenoma) or cancerous (carcinoma). A more accurate criterion in this situation would be the ratio of free PSA to total.

An increase in the number of antigen up to 20 ng / ml with a high probability (50%) indicates a malignant neoplasm, which can already metastasize to the nearest organs. Therefore, after confirming the diagnosis by prostate biopsy, a complete examination and search for other lesions is indicated.

Exceeding the norm by 4-5 times does not mean the presence of a fatal diagnosis. Such a result may be a false positive, caused by infections of the prostate or a large adenoma.

An amount of antigen exceeding 30 ng / ml is extremely rarely provoked by mechanical irritation of the prostate before blood sampling, as well as inflammatory or benign processes. A comprehensive examination of the body and the identification of metastases are required. If the indicators exceed 40 ng / ml, this can only speak of stage 3-4 cancer, which has practically no chance of being cured.

Percentage of antigen

In order to distinguish carcinoma from hyperplasia or inflammation, the amount of free prostate antigen to the total volume is calculated. Normally, this figure is approximately 10-15%.

Adenoma provokes the growth of protein in the free fraction, while carcinoma, on the contrary, increases the concentration of bound protein.

Thus, with a result of more than 15%, there is reason to believe that the overall increase in PSA is not associated with cancer. With a decrease in the indicator relative to the norm, there is a high risk of a cancerous tumor.

What influences a false positive result

In some cases, an increase in the amount of PSA is also recorded against the background of a man's complete health. The reason for this is:

• mechanical irritation of the gland 72 hours before blood sampling (cycling, prostate massage, rectal palpation or ultrasound);
• sexual intercourse, masturbation, uncontrolled ejaculation three days before analysis (sexual rest is recommended for a week before the procedure):
• prolonged urinary retention immediately before the procedure;
• Installation of a urinary catheter 3 days before analysis.

If such circumstances could affect the result, tell the doctor about it.

In addition to the tumor, an increase in the antigen in the blood is caused by inflammatory processes in the prostate gland, STDs, hormonal disorders, and strong emotionality during the procedure.

Don't panic if you see high scores in your analysis results. The PSA level is only one of the factors that can indicate the oncological process. A biopsy will give an accurate diagnosis.

PSA change during therapy

The higher the content of the antigen, the greater the likelihood of a malignant neoplasm of the prostate. Statistics show that when PSA is indicated:

• from 2 to 4 ng/ml - percent probability of carcinoma - 18%;
• 4 to 6 ng/ml - 21%;
• 6 to 8 ng/ml - 28%;
• from 8 to 10 ng/ml - 32%;
• more than 10 ng/ml - 56%.

At readings above 20 ng/ml, the chances of a false positive result are negligible.

PSA versus cancer stage

Quantitative analysis of the antigen also shows the approximate stage of tumor development. If the PSA data is confirmed by a biopsy, with a high percentage of probability:

As long as the tumor has not gone beyond the gland, successful treatment and complete recovery are possible. With the appearance of the first metastases, the chances of getting rid of carcinoma are reduced. Therefore, it is especially important to identify the tumor at the very beginning of its growth.

Influence of therapy on PSA

With a positive effect of therapy on diseases of the male prostate gland, the PSA value gradually decreases and returns to normal. It is important to control the growth of antigen in the blood 2-3 times a year. If a sharp jump is noticed, malignancy of hyperplasia is possible. A slight increase in the amount of PSA is the norm for this disease.

An indicator of successful treatment of carcinoma by radiation / chemotherapy or partial resection of the gland and the achievement of a state of stable remission is the result of an analysis that is close to normal. With the complete removal of the organ, the amount of antigen in the blood gradually disappears and subsequently does not exceed 0.2 ng / ml.

To check the effectiveness of treatment, blood sampling for PSA is carried out every 3 months, but not earlier than 30 days after prostate resection.

Reducing the antigen and restoring the normal functioning of the gland takes 2-3 years. All this time, the indicators should decrease.

A repeated increase in PSA indicates the emergence of a new focus of inflammation and requires the resumption of therapy. Even complete removal of the prostate does not guarantee getting rid of carcinoma.

Additional examination for high PSA

As already noted, an elevated level of prostate antigen does not diagnose cancer, but is only a sign of its presence. Only a biopsy is able to determine the type of tumor and the stage of its development with 100% probability. The material taken from several parts of the gland is examined in detail for the presence of cancer cells and the degree of their growth.

Biopsy is a traumatic process, unsafe for the organ. An increase in the number of PSA is not a direct indication for e-carrying out. To begin with, the doctor will prescribe a diagnosis for the patient using:

• palpation;
• Ultrasound with rectal probe;
• MRI or X-ray, if imaging equipment is not available.

If there are several indicators of the development of carcinoma, the material is taken for a biopsy. The procedure takes place under general or local anesthesia, usually does not require hospitalization of the patient.

If the biopsy result is positive, then a contrast computed tomography of the whole body or a gamma image is indicated to detect tumor metastasis and choose a course of treatment.

Effectiveness is monitored by repeating the PSA test and biopsy.

Prostate tumor markers

A tumor marker is a special protein, the indicator of which shows the development of a malignant tumor. Such indicators are used for early diagnosis of oncology and detection of metastases.

It is important to understand that even a slight increase in the oncomarker in the blood characterizes the presence of a benign formation and inflammatory processes. As a rule, a single increase in the oncomarker index does not indicate the presence of oncology, but serves as a reason for examination.

General information about tumor markers

Okomarker is a protein that can be detected by urine or blood tests. Cancer cells tend to produce, due to which tumor markers are released into the blood. It is thanks to oncomarkers that it is possible to identify the disease at an early stage of its development. Timely examination will allow not only to assess the treatment, but also to prevent relapse. To date, there are about two hundred compounds related to oncomarkers. However, only twenty can be called reliable. To determine the condition of the prostate gland, only a few tests are performed.

Cancerous-embryonic antigen

The normal rate in older men does not exceed 5 ng / ml. A slight excess of this indicator may indicate the presence of a malignant formation in the prostate gland. However, the study should focus on the clinical picture as a whole, since such an indicator can also indicate stomach cancer, tuberculosis, chronic liver failure, hepatitis and other autoimmune diseases.

Chronic human gonadotropin

Elevated hCG levels can detect oncology. An indicator not exceeding five IU / ml is considered the norm. A cancerous tumor can be suspected if the indicator is equal to ten IU / ml.

PSA: norm, results, preparation

Today, medicine offers several options for detecting prostate cancer. However, the PSA test is the most accurate. Prostate specific antigen is an ocomarker that is used to diagnose the detection of malignancy. It is thanks to this antigen that it is possible to detect tumor cells in a timely manner and make a diagnosis. Exceeding the indicator in the blood can speak not only about the presence of a malignant formation. Prostatitis and prostate adenoma may also be accompanied by an increase in antigen levels. But it is precisely a consistently high level of antigen that indicates the presence of oncology.

The level of PSA, as a rule, increases in parallel with the volume of the gland and the age of the patient, therefore, the rate of the indicator also increases in parallel with these indicators.

The rate of the indicator should be within 4 ng / ml. The norm is considered international, and there are no other values. Each age has its own indicators:

• 40-50 years old, PSA level should not exceed 2.5 ng/ml;
• 50-60 years old, PSA level should not exceed 3.5 ng/ml;
• 60-70 years old, PSA level should not exceed 4.5 ng/ml;
• 70-80 years old, PSA level should not exceed 6.5 ng/ml;

A reading below 2.5 ng/mL, with normal palpation results, indicates that the patient is healthy. A re-test is scheduled in a year. However, in the case of normal palpation results, but with elevated values, more than 2.5 ng / ml, a biopsy is necessary.

What is the difference between them?

In contrast to the free level of PSA, the percentage of total antigen is 90. The common tumor marker is closely associated with proteins that are secreted by the prostate gland, while the free one is not associated with them. The only thing that connects these two fractions is that they are taken into account in the analysis when detecting oncology.

If the ratio of the free antigen level to the total level is less than 0.15, this may indicate the presence of a malignant formation. With prostate adenoma, this figure will be much higher.

Variations in results

Today, everyone can face prostate dysfunction. But not every change indicates the presence of pathology. High concentration may be due to:

• Prostate adenoma.
• Palpation of the prostate.
• Prostate massage
• After ejaculation.
• Biopsy.
• Catheterization.
• Injury.

Therefore, proper preparation is necessary for analysis.

Preparation

Each patient, when taking the test, must comply with all the doctor's instructions, otherwise the test results may be incorrect, which will lead to a second pass. Before passing, the patient must:

Other methods of diagnosing oncology

Tumor markers are not the only option for diagnosing oncology. The attending physician may also prescribe to the patient:

But we must remember that none of the methods is able to accurately determine the stage of oncology. Only the totality of all studies will make it possible to identify and determine the stage of malignant formation of the prostate gland by conducting a qualitative assessment of the oncomarker.

PSA, or prostate specific antigen, is a homogeneous protein substance that is produced by prostate cells. PSA is found in the ducts of the prostate, helps to thin the seminal fluid. Blood for PSA analysis is taken from a vein in the morning. Until the age of 40-50, it is recommended to take such an analysis as part of a general medical examination. After 50 years, it is necessary to take such an analysis regularly, at least once a year. The value of PSA can vary greatly, in patients after 50 years it increases, it can be much higher than the norm, which must be taken into account during the study. The number of antigens is influenced by the intake of certain medications, certain manipulations in the prostate gland, organ biopsy, and so on. Violation of indications can be noted in patients who are undergoing chemotherapy. It is worth considering that there are a number of drugs that have such an effect.

Why is a PSA test ordered?

An analysis is performed when there is a suspicion of prostate disease. Among the main reasons why research may be required are the following:

• prostate cancer;
• presence of inflammatory processes in the prostate;
• hyperplasia, benign formations;
• prostate infarction, suspected ischemia;
• as a preventive examination;
• to control treatment for an existing disease.

The analysis of the prostate tumor marker itself is a blood sampling from a vein; a number of simple measures must be taken before the examination, which ensures the accuracy and quality of the data obtained. You can not drink alcohol before taking the test, eat too spicy food, engage in vigorous exercise or sex on the eve of the test. In more detail about how the examination will be carried out and what results will be obtained as a result, the observing specialist will tell. All measures must be observed exactly, since often the apparent norm does not really mean at all that there is no disease. Therefore, a comprehensive examination can be prescribed.

Preparation for the examination

Analysis for tumor markers requires preparatory measures. For about a day or two, you need to give up too fatty and spicy foods, from alcohol.No special diet is required, but spicy foods and alcohol can adversely affect the result. Blood donation can only be done on an empty stomach, like any other study. The last meal is taken approximately 8 hours before the blood is donated. It is recommended to refrain from smoking about an hour before donating blood.

Before the analysis, cycling, sports, gymnastics should be excluded. It is necessary to refrain from all those actions in which the prostate gland experiences any pressure, effects on tissues, changes in blood circulation, and so on.

Performing the procedure

PSA blood sampling for prostate adenoma should be carried out before 11 o'clock in the afternoon to minimize the risk of destruction of the integrity of the blood cells taken for analysis. But there is one more condition - such an analysis is required to be taken only 6-7 days after the prostate has had any mechanical effect. Tumor markers are strongly influenced by the following procedures:

• transrectal ultrasound;
• prostate massage;
• ergometric study;
• biopsy;
• cystoscopy, colonoscopy, which have a strong effect on tissues;
• laser therapy prescribed for treatment;
• Digital rectal examination

If you do not comply with such simple conditions, then the norm may be violated, the analysis itself will not give reliable indicators, you will have to do everything from the very beginning. If the preparation is not properly carried out, it is necessary to inform the specialist who will reschedule the examination to another day or take into account such violations.

Research results

Inflammatory processes in the prostate lead to the fact that vascular permeability increases, there is a violation of microcirculation. Such processes are caused by an increase in PSA in the blood. The onset of the disease or the risk of its occurrence is easy to determine, but at the same time, diagnosis is difficult, since additional examinations are required to clarify the results.

Specialists recommend checking the PSA index for all men over 50 years of age as a preventive measure. It does not take much time, but there is an opportunity to detect the disease in time, to start treatment that will be effective.

PSA in the blood can be in two forms:

• non-protein bound free;
• associated with proteins.

The norm is usually up to 4 ng / ml, but the figures above already indicate a risk of morbidity.

Anything greater than 40 ng/ml already proves the presence of metastases, and not just a developing disease. But it must be remembered that tumor markers do not give one hundred percent certainty that there is no disease. Today, more and more situations arise in which cancer and other neoplasms are diagnosed even with a normal PSA.

With adenoma, the value is usually observed from 0.75 ng / ml, there is an increased likelihood that cancer develops.

The very procedure of taking blood for analysis, in order to determine an adenoma or suspicion of it, is carried out with the following preparatory measures:

The analysis itself is carried out in this way:

Which indicators correspond to the norm?

Antigens in the blood can have different contents, during the study it should be taken into account that the norm, which is 0.2-4 ng / ml, may depend on the age of the patient. To do this, experts use the following data:

• 40/49 years - the norm is 2.5 ng / ml;
• 50-59 years - 3.5 ng/ml;
• 60/69 years - 4.5 ng/ml;
• 70/79 years - 65, ng/ml

There are a large number of factors that distort the readings, as a result, antigens can have completely different volumes. Among these factors are chemotherapy, hemolysis of blood taken for a sample, finasteride, methotrexate and other drugs that may be taken by the patient.

The analysis itself, which shows how many antigens are in the samples, is carried out for the following purposes:

The antigens in the blood and their amount allow the specialist to determine the presence of the disease, its stage. You can get the following data:

After treatment, the level drops to 0.2 ng/ml.

PSA norm in men

After the PSA oncomarker was examined, the specialist makes a conclusion about whether there is a deviation or a norm. Only then the doctor selects a course of treatment.

The norm is possible in such cases:

• presence up to 4.0 ng/ml;
• presence of a free tumor marker - 0.04-0.5 ng/ml.

The norm is not determined if there are such deviations:

Examination for tumor markers helps the doctor determine whether there are benign or malignant neoplasms of the prostate gland. An examination is prescribed only by a doctor who, based on the results, makes his conclusion and prescribes additional examinations.Normally, tumor markers are observed up to 4 ng / ml, but if this value is higher, then we can already talk about the presence of the disease. With a large number, not only a neoplasm is already observed, but also metastases penetrating into other organs.

Prostate cancer develops from the glandular tissue of the prostate and most often affects men over the age of forty

As experts say, the prostate gland is the "second heart" of a man. It plays an important role in fertility, regulates the emotional sphere and autonomic function. After forty years, men are prone to the development of prostatitis, adenoma and prostate cancer. Oncological diseases of the prostate gland often proceed hidden, masquerading as another pathology.

PSA tumor markers (total and free) are the only diagnostic method that allows you to make a diagnosis at the preclinical stage of the disease. By their level in the blood, you can judge how the prostate works. In this regard, the determination and interpretation of PSA tumor markers must be carried out annually for men who have reached the age of forty.

Methods for diagnosing prostate cancer

Diagnosis of prostate diseases begins with a digital rectal examination. In this way, it is possible to detect organ cancer with a large mass of the tumor

To diagnose prostate cancer, other research methods are also used, such as transrectal ultrasound of the prostate (ultrasonography), computed tomography, X-ray of the pelvic bones and their scanning using a radioactive isotope. However, these methods do not replace the determination of the level of tumor markers - PSA total and PSA free.

Prostate-specific antigen (PSA) structure

Prostate-specific antigen (PSA) is a glycoprotein with pronounced protease activity. It was first identified about fifty years ago. Excretion of PSA occurs in the epithelial cells of the prostate gland. It is secreted into the seminal fluid and is an important part of the ejaculate, as it provides sperm liquefaction.

There is usually a minimal amount of PSA in the blood. The PSA molecule can be associated with alpha one antichymotrypsin) and alpha two macroglobulin. Eighty-six percent of the PSA tumor marker that circulates in the human body is in the form of a PSA-AXT complex, and only a small fraction of PSA can be associated with alpha-two-macroglobulin. The latter complex is not determined by laboratory research methods. The concentration of the common oncomarker PSA determined in the blood is represented by it and the PSA-ACT complex. Over time, the level of the total tumor marker increases, and the percentage of free PSA in nm decreases significantly.

For what reasons can the PSA level change

The PSA tumor marker refers to specific markers of prostate tissue. An increase in its level can occur during any pathological processes - inflammation, benign or malignant neoplasms, traumatic injuries of an organ, therapeutic and diagnostic manipulations. An extremely important point is the study of the PSA level before the start of any procedures and the manipulation of the prostate gland.

After a prostate biopsy, an elevated PSA concentration is observed for three weeks. Transurethral ultrasound, prostate massage, rectal digital examination also lead to the fact that the PSA level becomes elevated. Even after ejaculation, there is an increase in PSA concentration for forty-eight hours. In patients with prostate cancer, a decrease in the content of the free fraction of the prostate-specific antigen is determined compared with men who have benign prostatic hyperplasia.

It was proposed to use such a calculated indicator as the percentage of free PSA for the differential diagnosis of benign and malignant neoplasms. It is calculated in this way: first, the level of total and free oncomarker PSA is determined in one analysis. Then, the mathematical ratio of the level of free PSA tumor marker to the total PSA tumor marker is calculated, and multiplied by one hundred percent. The Stanford PSA standard looks like this: ninety percent PSA-ACT and ten percent free tumor marker PSA.

This indicator is extremely important when increasing the PSA level to no more than 10 ng / ml. In such cases, the probability of an increase in the concentration of the antigen due to benign neoplasms or inflammatory processes in the prostate is very high. If the value of the indicator is more than twenty percent, then it can be assumed that there is a benign process, but if the indicator is less than fifteen percent, then it can be interpreted as an additional marker of a malignant process.

International guidelines for the diagnosis of prostate cancer

International experts recommend an annual digital rectal examination, combined with the determination of the common tumor marker PSA, in men under the age of fifty who have a moderate risk of prostate cancer. If male representatives have a aggravated history, that is, one of the first-line relatives had prostate cancer, then at the age of forty to forty-five years they should also undergo such an examination.

There is no doubt that the determination of the PSA level is the best laboratory test, but the results of the interpretation of the PSA tumor marker values should only be interpreted in conjunction with clinical data obtained through a physical examination. An elevated level of the total PSA tumor marker should always be accompanied by a determination of the percentage of the free PSA tumor marker. This gives an opportunity to carry out differential diagnosis of benign and malignant processes in the prostate gland.

The greatest diagnostic value of determining the level of PSA in general for the prognosis of the effectiveness of treatment (determination before the start of treatment), monitoring of treatment (decrease to an undetectable level in patients with removed prostate gland), control of recurrence and metastases (increases 6-18 months before clinical manifestations).

Research and interpretation of PSA tumor markers

Most laboratories use an immunochemical method for determining the level of PSA with electrochemiluminescent detection. Preparation for analysis is as follows:

• blood to determine the level of total PSA tumor marker and free PSA tumor marker is taken in the morning, on an empty stomach;
• you should exclude the use of alcoholic beverages, food, smoking and limit physical activity twelve hours before the blood test;
• On the morning of the study day, a glass of water is allowed;
• it is necessary to stop taking medications, if it is impossible to cancel them, then it is necessary to inform the laboratory assistant about it;
• During the two days prior to the study, the man must abstain from sex and not masturbate.

The PSA tumor marker (norm) is different depending on the age of the man. So, at the age of forty years, its level should not exceed 1.4 ng / ml, from forty to fifty years - 2.0 ng / ml, from fifty to sixty years - 3.1, up to seventy years - 4.1. In men over the age of seventy, the PSA level should not exceed 4.4 ng / ml.

The level of prostate-specific antigen is increased by massage and ultrasound of the prostate, biopsy, as well as rectal finger examination. Its level decreases after ejaculation and taking the drugs Finasteride and Dutasteride.

Indications for PSA testing

This study is carried out in the following cases:

• for screening and early diagnosis of prostate cancer;
• as an additional marker of prostate cancer to the results of rectal examination;
• to determine the PSA level before starting treatment;
• to monitor the effectiveness of prostate cancer treatment;
• for the purpose of screening for tumor recurrence and metastasis.

PSA tumor markers - transcript

An increase in PSA levels is possible in such cases:

• in inflammatory diseases of the prostate gland (prostatitis);
• in case of benign prostatic hyperplasia;
• in the presence of prostate cancer;
• after injuries, surgeries, diagnostic manipulations in the prostate area (rectal examination, ultrasound, massage, biopsy);
• due to ejaculation on the eve of the study;
• in acute renal failure and acute urinary retention.

Determination of the level of free and total oncomarker PSA is indicated for the differential diagnosis of benign hyperplasia and prostate cancer. If you suspect a prostate disease, you should immediately contact a urologist.