Prostatic specific antigen and its usefulness in clinical practice

Hippokratia 2000, 4(4):157-162

V. Rombis, S. Touloupidis, G. Fatles, E. Balaxis, K. Vakalopoulos


Many advances have occurred during the last decade in the clinical use of prostate specific antigen (PSA) for detecting, staging and monitoring prostate cancer. We review the clinical usefulness of serum PSA as a tumor marker of prostate cancer.The international literature was reviewed from 1986 to 1999.Although controversial, age specific PSA reference ranges can improve the sensitivity for prostate cancer detection in young men and the specificity in older men. Percent free PSA improves the specificity for prostate cancer detection in men with PSA values between 4 and 10 ng/ml, and a PSA density of greater than 0.15 may better distinguish benign prostatic hyperplasia from prostate cancer. PSA velocity can improve the ability to detect prostate cancer when 3 serial PSA values are measured during a 2-year period. PSA is the most clinically useful tumor marker to monitor recurrence of disease after treatment of prostate cancer. PSMA and RT-PCR are relatively new promising laboratory methods detecting prostate cancer cells in the blood or bone marrow.PSA remains the best and most widely used tumor marker in urology today but there is lot of ambiguous spots to be turnout.