Prostatecanceristhemostfrequenttypeofcancerfoundinmanandisthesecondcauseofdeathduetocancerinmales.Untilrecently,digitalrectalexamination(DRE)wasfrequentlyusedasonlydiagnosticmodalityforthedetectionofearlystagesofprostatecancer.IntherecentyearsthedeterminationofserumPSAlevelshasbecomethemostacceptedmethodtoimprovethediagnosticspecificityofDRE.AlthoughPSAisatissuespecificproteinandisnotsolelytumorspecific,ithasbecomethemostimportant
Markerforprostatecarcinoma,showingabetterspecificitythanotherbiochemicalmarkersusedinthiscontext(PAP,totalalkalinephosphatase,carcinoembryonicantigen,etc.)In1979,WangetalisolatedaspecificantigenfornormalprostatetissueandcalledthisproteinPSA.Asdemonstratedbyimmunohistologicalstudies,PSAislocalizedinthecytoplasmofprostateacinarcells,ductalepitheliumandinthesecretionontheductallumina,presentinnormal,benignhyperplasticandmalignantprostatetissuesaswellmetastaticprostatecancerandinseminalplasma.Ifthestructuralintegrityoftheprostateisdisturbedand/ortheglandsizeisincreased,theamountofPSAinthebloodplasmamaybecomeelevated.AnelevationofPSAlevelstovalueshigherthan3-4ng/mLhasbeenreportedforpatientswitheitherbenignprostatichypertrophy(BPH)orprostatecarcinoma.Atthisthresholdfollow-upexaminationsthatallowdifferentiatingbetweenthesetwoconditionsarerecommended.ThedeterminationofPSAserumlevelsisnotonlyimportantforthescreeningofpatientsforprostatecancer,butalsoformonitoringpatientsthathavebeentreatedforthisdisease.HereregularPSAmeasurementsareanimportanttooltoexaminethepotentialandactualeffectivenessofsurgeryorothertherapies.AnincreaseofPSAinpatientsafterr
ADIcalprostatectomyorradiotherapymayallowanearlierdiscoveryofresidualorrecurrentcarcinoma
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