Clinical Study on the Correlation between Serum PSA、Free PSA and Benign Prostatic Hyperplasia
|School||China Medical University|
|Keywords||BPH PSA Free PSA|
Clinical study on the correlation between serum PSA、free PSA and benign prostatic hyperplasiaObjectiveTo evaluate the clinical factors that may influence serum prostate specific antigen(PSA)、free PSA level in patients with benign prostatic hyperplasia(BPH). To approach the correlation between prostate specific antigen in serum、free prostate specific antigen in serum and prostate volume、prostate transition zone volume、age、international prostate symptoms score、quality of life in patients with benign prostatic hyperplasia.MethodsA total of 40 cases of BPH diagnosed by pathological examination following operation were analyzed prospectively. The patients’ mean age was(72.5±6.3) years. The International Prostate Symptom Score(IPSS)was 26.8±3.7; the Quality Of Life(QOL)was4.9±0.75; Prostate Volume(PV)was(79.6±35.6)ml; and Prostate Transition Zone Volume(TZV)was(45.5±23.6)ml; pre-operation using the Chemiluminesent Microparticle Immunoassay to determine the value of PSA and free PSA in serum in 40 patients with BPH, meanwhile using per-abdomen color ultrasound to measure the left and right diameter、the supra-hypo diameter and the anteroposterior diameter, the calculation of the total volume of prostate used the formula PV=(the anteroposterior diameter×the left and fight diameter×the supra-hypo diameter)π／6. The patients accepted IPSS and QOL score at the same time, the patients with prostatic carcinoma had been removed. Post-operation determined the prostatic volume of the excisional prostate I.e.TZV. Used the SPSS 10.0 statistics software to carry out statistical treatment, utilized correlation analysis method to carry out the correlation analysis between PSA、free PSA and TZV、PV、age、IPSS、QOL score.ResultsOf the 40 cases, 14 cases (35%)had serum PSA level at 4～10ng/ml, and 10 cases(25%), over 10ng/ml.. The patients’ mean age was (72.5±6.3) years; prostate volume (PV) was (79.6±35.6) ml; and prostate transition zone volume was (45.5±23.6)ml.. PSA, Free PSA, fPSA/tPSA, PSAD and PSATZD was (9.52±9.34)ng/ml, (2.13±1.73)ng/ml, (28.8±16.4)%, (0.12±0.10)ng/L~2 and (0.28±0.13)ng/L~2 individual. The International Prostate Symptom Score(IPSS) was 26.8±3.7; the Quality Of Life(QOL) was4.9±0.75. Free PSA showed stronger correlations with PV、TZV and IPSS score than did PSA.. The level of serum PSA and free PSA were associated with PV, TZV, age, IPSS (r=0.52 with 0.63、all of P＜0.01; 0.55 with 0.64、all of P＜0.01; 0.24 with 0.40、P＜0.05 with P＜0.01; 0.21 with 0.23、all of P＜0.05). PSA and free PSA had no statistically significant correlation with QOL score (all of P exceed 0.05).ConclusionsThe free PSA compare to the PSA shows a stronger relationship with PV, TZV, age, IPSS. PSA and free PSA had no statistically significant correlation with QOL score. Elevated serum PSA and free PSA level were observed in more than 50% of BPH patients undergoing surgical resection. Enlarged prostate volume、transition zone volume、high age and high IPSS scores considered to be the main causes leading to elevated PSA and free PSA level in BPH patients. The high PSA, the free PSA value may indicate that the clinical symptom of BPH is more heavy, the possibility of needing the surgical operation to interfere is higher, meanwhile may indicate bigger prostate gland volume. To the patients with prostate gland disease, should considerate the PSA、free PSA value, the prostate gland volume, age, IPSS score and digital rectal examination(DRE), according to the concrete circumstance to make the individual analysis.