Since PSA is considered a prostatic tumor marker, when appointed, many men panic, and exceeding the norms according to the results of the analysis drives them into depression and literally makes them impotent. The doctor must explain to the patient the nature of the appearance of antigen in the blood. Normally, it is concentrated in the tissues of the prostate and is protected from the bloodstream by the cell barrier.
In case of violation of the protective structure (damage to the capillaries of the histohematological barrier), PSA penetrates the blood and its total volume grows. Damage can be triggered not only by cancer, but also by a number of other factors: prostatitis, hyperplasia, allergies, intoxication, perineal injury, intake of vitamin C, nitrates.
Urologist, dermatovenerologist Lenkin Sergey Gennadievich more about PSA analysis
PSA analysis is needed for the following purposes:
- In the initial diagnosis to confirm pathological processes in the prostate. The basis may be a digital examination or ultrasound, during which suspicious lesions in the gland are detected.
- For the timely detection of prostatic hyperplasia and oncology in men with poor heredity (if these pathologies affected the father or grandfather), as well as for monitoring health in people over 45 years of age.
- During the treatment of cancer to track the dynamics. If the indicator grows – the tumor progresses, metastasizes, if it decreases – therapy gives an effect. The marker is also used to monitor the effectiveness of the treatment of adenoma, including after its surgical removal.
According to the recommendations of the European Association of Urology, a man should donate blood for the first time on a prostatic marker at the age of 40, and the further multiplicity is determined by the result obtained. If the concentration of glycoside does not exceed 1 ng / ml, then it makes no sense to take an analysis more often than once every 8 years. For men over 75 years of age, this diagnostic method no longer has clinical significance, so screening is pointless. According to statistics, the treatment of cancer detected at a given age kills faster than the disease itself.
In medicine, it is customary to isolate a free and common PSA tumor marker. What is the difference? In the blood plasma, 2 types of specific prostatic antigen can be detected:
- associated with blood serum proteins (trypsins and globulins);
- unrelated to blood proteins (free).
A common PSA is the sum of bound and unbound antigens. For diagnosis, the indicator of both the total and free fractions is important.
It is important to determine not only general but also free PSA. If the indicator of unbound protein exceeds the norm, then this most often indicates benign prostate tumors.
As already mentioned, with prostate cancer there is a high level of total PSA. In cancer, the content of trypsin proteins with which the antigen binds increases. However, in patients with prostate cancer, the concentration of free PSA is significantly reduced.
In the decoding of the analysis on the tumor marker, the ratio of the total and free fraction in percent must be indicated. To calculate it, you need to divide the value of free PSA by an indicator of total PSA, and then multiply by 100. This ratio helps doctors to predict the outcome of the disease:
- If the ratio is from 15 to 100%, then this indicates a positive outlook.
- An indicator below 15% indicates a possible adverse outcome of cancer.
Men suffer from malignant neoplasms in the prostate gland. To detect the disease at an early stage, they take a blood test for PSA. Consider how the results are decrypted.
PSA (Prostatic Specific Antigen) is an ovarian protein that dilutes the seed. Given age, the health status of PSA is not the same. PSA is called a cancer marker, which helps to detect oncology at the initial stage of the disease.
In order to control the health of the prostate, they are cyclically tested, called a “tumor marker” in medicine. Having deciphered the results, the doctor will determine the presence (absence) of the disease. PSA is also detected in healthy people. This is the norm, because the synthesis of globulin is continuously carried out in a small fraction.
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- When needed
- PSA analysis: indications, preparation, norms, interpretation of the results
- PSA standards
- PSA for cancer
- General and free
- PSA blood test: deciphering what it is, general PSA, preparation and norm
- The study of tumor markers
- PSA increase rate
- PSA analysis: what it is, why and how to take these tests, preparation for passing a blood test for a dog, norm, decoding of results
- PSA analysis: what it is, why and how to take these tests, preparation for passing a blood test for a dog, norm, decoding of results
- If PSA is elevated
PSA helps control the process to schedule an operation on time. Overestimated indicators do not always indicate oncological processes in the body. Cancer is also diagnosed with low ratios.
Indications for analysis:
- symptoms of prostate disease;
- refutation, confirmation of malignant neoplasm;
- monitoring therapy in cancer treatment;
- detection of the resumption of the disease after surgery;
- activity in harmful working conditions;
- malfunctioning of the genitourinary system;
- the presence of a tumor in relatives, heredity;
- pelvic diseases.
PSA studies help detect cancer in the early stages of men and evaluate the effectiveness of tumor treatment.
Prostate cancer is one of the causes of death from cancer in men. At the initial stage, it has mediocre manifestations: pain, impaired urine output. Often occurs without symptoms. Screening helps to detect the disease: examination by a urologist and passing a PSA test (venous blood sampling).
To maintain good health, it’s important for men to know what a PSA blood test means. Antigen levels indicate whether the prostate is healthy.
Decipher the results according to the age of the patient, which makes it possible to distinguish the limit from the deviation, to find the risk group. The following factors influence the conclusion of the urologist: the difference between the typical indicator and the result of the examination, PSA index.
PSA analysis norm for men:
Watch a video that tells what PSA analysis is and what is the norm for healthy men.
For persons under 40 years of age, the norm is 2,5 ng / ml. The older the man, the higher the level of antigen in the blood. Seniors are advised to do an analysis every year. The doctor makes interest in the table and monitors their changes.
In order for the results to be reliable, they are prepared correctly for examinations:
- follow a diet for several days, do not eat on the eve (for 10 hours), water is allowed;
- exclude physical activity;
- reduce emotional stress;
- do not smoke one hour before delivery;
- do not take medication;
- 2 days before the analysis, intimacy is avoided.
The reasons for the increase are various. An increase in the level does not always indicate oncology. Sometimes an increase in PSA is false when recommendations are not followed before analysis. True causes of high levels: adenoma, tumor, prostatitis. The antigen index increases with the aging of men.
When the level of PSA rises, urination and ejaculation are painful, the temperature rises, squeezing in the perineal region is felt, sexual function is impaired.
The rate of prostate-specific antigen increases due to infections affecting the urethra, bladder. Symptoms – pain, burning sensation during urination, blood clots in the urine.
To reduce the level of PSA, use the following methods:
- Reduce the consumption of foods that contain fats and proteins – dairy products, pork, butter. They will cause an increase in pathologies.
- Drink 1,5 liters of water per day.
- They eat fruits and vegetables.
- Eat fish, seafood.
- If deviations are found, it is the responsibility of the doctor to find out the cause.
Note! Indicators reduce naturally, prescribe medications. If the pathology is confirmed, the urologist selects the method of treatment.
When diagnosing PSA growth sources, false reasons are taken into account. A slight excess in the concentration of antigen in the blood indicates changes in the functioning of the prostate gland that do not have pathologies.
They are taken into account when decoding the results. To confirm or refute the development of prostatitis, an additional laboratory examination is performed.
The PSA index in the blood varies depending on the degree of spread of the cancer.
According to the results of the analysis, the phase of the cancer is specified:
- First one. The size of the tumor is insignificant, there are no symptoms. PSA ratios are slightly above normal – up to 10 ng / ml.
- The second one. The neoplasm grows, does not go beyond the borders of the prostate. The patient is disturbed by inconvenience, pain during urination, sexual intercourse. The coefficient is 10 – 20 ng / ml.
- The third. The neoplasm leaves the gland, spreads to nearby tissues, organs. Concentration over 20 ng / ml.
- Fourth. Cancer with an antigen concentration greater than 40 ng / ml.
To clarify, a blood test is repeated.
Timely determines the presence of pathology in the prostate. The value of total antigen should not exceed 4-10 ng / ml. If the patient is diagnosed with prostate cancer, the number of free PSA will be less.
- examines the prostate for preventive purposes;
- detects an ailment in the primary stage;
- gives an assessment of the results of therapy.
Free form determines whether or not dangerous changes in the prostate gland. To make a correct diagnosis, they take a blood test for PSA in two types.
PSA total and free – the components of a joint formula: free antigen linked = total. If after the analysis deviations are found, in order to clarify the diagnosis, the ratio is determined.
|30 – 45 years||0,7 – 1,9||Less than 0,5|
|50||0,7 – 2,5||0,5 – 10,5|
|55||1,1 – 3,3||0,7 – 2,1|
|60||1,4 – 3,5||1,1 – 3,2|
|70||2,1 – 4,5||1,2 – 3,3|
|От 70||2,3 – 6,5||0,7 – 3,4|
Using tabular information to identify changes in the norm. They warn of cancer damage. Depending on the type of PSA blood test, the results of its decryption for men will differ. A slight increase to average values is provoked by a pathological process, an enlargement of the gland. Excessive concentration confirms the pathology:
- 4-10 ng / ml – guesses about cancer education;
- 10-12 – a dangerous tumor;
- over 40 – the appearance of a secondary focus of neoplasm.
PSA analysis: indications, preparation, norms, interpretation of the results
Men over 45 years old should do a PSA blood test to monitor age-related physiological changes. For preventive purposes, take an analysis once a year.
Every year, check the level of antigen in the blood should also be in the presence of the following indications:
- if someone from close relatives has been diagnosed with cancer;
- if a person works in harmful conditions;
- with suspected prostatitis or benign hyperplasia;
- if hormone therapy was performed;
- with urination disorder;
- there is blood in the urine or seminal flu >
In order to get the most reliable result of PSA analysis, it is necessary to prepare correctly.
- Refuse sexual activity two days before the procedure.
- Take an analysis on an empty stomach or not earlier than 6 hours after eating.
- Donate biomaterial no earlier than a week later if the patient has undergone: prostate massage, ultrasound, colonoscopy and other procedures that contribute to prostate irritation. If a prostate biopsy has been performed, PSA analysis can only be taken after a month.
- The doctor is required to inform about all the diseases and the medications taken.
In the treatment room, the patient takes blood from a vein and goes to the laboratory for research. The procedure itself takes about five minutes. The result is prepared in a few days.
Statistics on the spread of cancer of the prostate gland is sad. This pathology is found in men of all countries of the world. About 14 thousand men make such a diagnosis annually in Russia alone.
The insidiousness of the disease lies in the fact that for a long time it proceeds without symptoms that can appear only in the last stages of the process. Men seek medical help when the tumor already reaches a large size, spreads metastases with blood flow throughout the body, and itself is no longer operable.
All this can lead to disastrous consequences, because in such cases it is almost impossible for the patient to help in recovering and prolonging life.
Thanks to the appearance in medicine of such an examination as a blood test for a prostate-specific antigen, earlier diagnosis of malignant tumors in the prostate gland became possible. A blood test for a dog is a simple and reliable way to assess the condition of the prostate, check for the presence of a benign or malignant neoplasm in it.
The analysis for the dog is a real breakthrough in the field of diagnosis and treatment of oncology, because when a prostate tumor is detected in the early stages in 100% of cases, doctors manage to achieve full recovery of the patient. That is, a prostate-specific antigen acts as a tumor marker in medical diagnostics and allows you to save more than one life.
Speaking about the importance of such an examination as a blood test for a dog, you should study in more detail what it is.
Prostate-specific antigen (dog or psa) is a protein compound with enzymatic activity. In men, it is synthesized by prostate cells and secreted into the urethra, where it exerts its effect on sperm.
The main function of the antigen is to reduce the density of seminal fluid in order to ensure sperm motility and their ability to successfully reach the egg.
That is, the dog has a direct impact on the proper functioning of the male reproductive system, allows him to extend his family, having offspring.
Some organs of the human body have their own enzymes, which are normally excreted by them in the blood in small quantities. But when any pathological process occurs, these values can increase.
For example, with various malfunctions in the liver, a biochemical blood test will show an excess of ALT and AST.
In men, the situation is similar with the prostate gland and PSA, which by its nature is an enzyme.
In a healthy man, prostate-specific antigen is practically not released into the blood by prostate cells and is found in serum in very small quantities.
However, it is only necessary to arise any pathology in the prostate gland, whether it is infection, inflammation, benign or malignant formations, the active synthesis of the dog begins.
Consequently, a psa blood test will show enhanced results.
The uniqueness of the analysis lies in the fact that the content of the dog in the blood increases with diseases of the prostate gland, and has nothing to do with deviations of any other organs. Therefore, in diseases not related to the prostate gland, the level of the dog in the blood remains unchanged.
Medical studies confirm the presence of antigen in the cells of the mammary glands and uterus. This allows us to conclude that in women, the dog has blood in the blood, but in negligible amounts, without any diagnostic value. A blood test for psa is not performed for women.
As a rule, the doctor prescribes an analysis for the first type of antigen. A common dog allows you to identify pathology at the very early stages of development, but there are situations when doctors resort to analysis and the second type of antigen. This happens if the first analysis revealed a deviation and the diagnosis is required to be clarified.
The value of the free dog to the total can be from 12 to 100 percent. The lower the percentage, the higher the risk of having oncology.
In medical diagnostics, there is such an indicator as the annual growth of the dog, which is measured in ng / ml / year. It is used when a man is diagnosed with a malignant tumor, to determine its aggressiveness and growth rate.
Analysis for the dog periodically must be passed to all men. This is especially true for those whose age has reached 50 years or more. Doctors recommend taking this examination at least once a year. You should not neglect these recommendations, as in some cases this can literally save a life.
Blood for a prostate-specific antigen is taken in an amount of 5-10 ml from a vein at the elbow. After that, laboratory assistants separate the plasma and leave the serum in which the amount of dog is checked.
To such a laboratory examination, as a blood test for a dog, it is better to approach with all responsibility.
This will help save time, nerves and funds that may be needed if the psa analysis has to be retried.
This happens in cases where the patient is not prepared properly, because the results of the analysis can be distorted from any, even the slightest factor. Therefore, it is better to start the preparation in a few days.
Preparation for a blood test for a dog is not very difficult and consists in the following:
- like many laboratory tests, the analysis of the dog is carried out until 12 o’clock in the morning, on an empty stomach. Therefore, in the morning you can not eat food. In the evening, an analysis is acceptable, but provided that the patient will not take food and drinks for 8 hours;
- 12 hours before analysis, coffee, tea and alcohol should be discarded. And in 24 hours – from eating fatty foods;
- smoking men half an hour before taking biomaterial should refrain from using cigarettes;
- a few hours before taking blood, it is necessary to maintain emotional calm, avoid stressful situations;
- a day before the analysis of the dog will be passed, you should refrain from playing sports. This is especially true for those sports that can affect the blood supply to the pelvic organs. This includes horse riding and cycling;
- It is important to refrain from having sex for a period of 5-7 days until the time of blood donation. The same goes for masturbation. This is due to the fact that the ejaculation process can significantly distort the blood test of the dog and the results will be unreliable;
- if any mechanical effect was exerted on the penis (for example, examination by a urologist), then blood sampling should be postponed for two weeks;
- if material was taken for analysis of a biopsy of the prostate gland, then blood for analysis of the dog must be taken one month after this procedure;
- if a man underwent surgery to remove a fragment of the prostate gland, then the analysis must be postponed for six months to avoid unreliable results.
Dog blood test and its decoding take time from 1 to 5 days, this period directly depends on the laboratory in which these tests are performed. As a rule, one day is enough.
The method for determining a prostate-specific antigen in the blood consists in the use of immunochemiluminescent analysis (IHLA), the basis of which is an immunological reaction. First, laboratory assistants identify the dog, and then attach phosphors to it – chemical elements that can glow in the dark.
The norm of the content of prostate-specific antigen in the blood is not more than 4 ng / ml (nanograms per milliliter). However, doctors are increasingly saying that such values are a bit overpriced.
In some cases, people who passed the blood test of the dog and learned the result of 4 ng / ml, nevertheless showed pathology of the prostate gland.
Doctors tend to consider the norm to be a value that is 3 ng / ml or lower.
The norm may vary in men depending on age. The fact is that the level of psa in the blood is directly proportional to the age of the man. With age, the volume of the prostate increases (about 3 mm per year), which significantly affects the psa blood test and its result. In other words, the older the subject, the greater the volume of his prostate and the higher the level of the dog.
- 40-49 years old – 0,5-1,4 ng / ml.
- 50-59 years – 0,7 – 2,0ng / ml.
- 60-69 years old – 0,9-2,6 ng / ml.
- 70-70 years old – 1,1-3,2 ng / ml.
If the patient who has passed the tests, the result exceeds the norm, this allows him to suspect such pathologies as:
- malignant neoplasms;
- infections of the genitourinary system;
- disorders of the bloodstream of the prostate gland.
At the same time, there is a certain pattern: minor excesses of the norm, as a rule, indicate the occurrence of inflammation or benign prostatic hyperplasia. And in the case of a significant excess of the norm, the patient usually confirms malignant changes in the prostate. And, the higher the result, the more the pathological process is launched.
- 4-10 ng / ml. Such indicators can serve as an occasion to suspect the development of oncology in a patient. Urologists and oncologists call this interval of values the “gray zone”. With these results, it is difficult to judge which process is occurring in the prostate gland in a man. These figures may indicate the presence of both a benign and a malignant tumor. And in some cases, pathology may be completely absent
- 10-20 ng / ml. Such data may indicate active growth of malignant tumors.
- 20 ng / ml and higher is a serious reason to suspect oncology, since such results usually indicate tumor metastasis. In the last stages of prostate cancer, a psa blood test can show results of 1000 ng / ml.
|Age||PSA rate in ng / ml|
|to 45 years||0 – 2,4|
|50 – 62||3,4 – 3,9|
|63 – 70||no more 4,4|
|from 70 years and older||not higher than 6,4|
If the total PSA is reduced, then this is considered a normal option and is not a sign of any disease.
The indicator of the free fraction of the prostatic antigen is also determined. Its concentration can be from 0,04 to 0,5 ng / L. Such values are the norm of the PSA tumor marker in men. The decryption of the analysis also indicates the percentage between the free and total fractions as a percentage. By this indicator, you can judge the prognosis of the disease.
PSA is present in the blood (f-PSA) in a free (10% of the total fraction) and protein bound form. The free form is normally 0,04-0,5 ng / ml. Usually, the total amount of the substance is first determined, and then, if necessary, a more detailed study is performed. The following indicators have diagnostic value:
- The ratio of bound and free PSA (free / total) x100%. In cancer, the bound form predominates, there is little free. A value below 15% means an unfavorable prognosis. If the volume of the gland is more than 40-60 cm 3, then the ratio is not informative due to the large volume of antigen-producing tissues.
- PSA growth rate. If they exceed 0,75 ng / ml per year, then there is reason to suspect the development of the oncological process.
- PHI – Prostate Health Index, biomarker. This is the most accurate indicator, taking into account PSA total, free, as well as -2 proPSA. The latter is a form of antigen that is produced by the peripheral parts of the prostate. Exceeding the norm gives reason to suspect cancer. The calculation of the index makes sense when the total PSA value is from 1,6 to 8 ng / ml (in some sources, up to 10 ng / ml). Formula: (p2PSA / fPSA) x (total PSA) 1/2. At a low value (lt; 23) the risk of cancer is minimal, with increased (gt; 45) – maximum. If the PHI is less than 28,1, then the biopsy is usually postponed and a second test is prescribed after 6-12 months.
PSA responds to any pathological change in the prostate gland. Normally, its amount in the blood does not exceed 4 ng / ml., However, this value is arbitrary. 15% of men are diagnosed with prostate cancer with antigen levels below the norm, therefore, recently, 2,5-3 ng / ml has been taken as the upper limit.
If the PSA value is in the range between 4 and 10 ng / ml, then the risk of developing oncology is 25%, more than 10 ng / ml – already 67%. In young men, the prostate volume is less, and PSA is lower, respectively. For them, a warning above 2,5 ng / ml will be alarming. In older people, iron naturally increases, PSA increases. Marker values for different age groups are summarized in table 1.
Table 1. PSA compliance with age groups
|Age range, years||Value, ng / ml|
|40 – 50||lt; 2,5|
|51 – 60||lt; 3,5|
|61 – 70||lt; 4,5|
|After 70||lt; 6,5|
With adenoma, the antigen level also rises and ranges from 4 to 15 ng / ml (average value is 9). It is impossible to differentiate a benign tumor from a malignant one by the amount of PSA. Only a biopsy can definitively confirm the presence of cancer. Under the control of ultrasound from each lobe of the prostate, 6 columns of tissue with a thread thickness are removed.
Для предварительного расчета риска рака простаты можно воспользоваться онлайн-калькулятором . Потребуется заполнить несколько полей: раса, возраст, уровень ПСА, данные пальцевого исследования и биопсии (если проводились). Уровень риска онкологии обозначается различными цветами и представлен в виде графического изображения. Калькулятор на английском языке, но перевод на русский можно сделать прямо в браузере.
PSA for cancer
During cancer treatment, the marker level slowly drops after chemo- or radiation therapy. In most cases, resort to prostatectomy (removal of the prostate). After surgery, the patient is under dynamic observation for 5 years. As diagnostic methods, finger research and analysis for PSA are used.
Click on image to enlarge
The half-life of glycoside occurs in 2-3 days, that is, approximately 2-4 weeks after surgery, its level should be below 0,1 ng / ml. The first study is carried out in a month, then every quarter. In the next 2 years, the analysis is done every 6 months, and then annually. Normally, the result should not exceed 0,05-0,2 ng / ml.
The PSA content in the blood varies depending on the age of the man – the older he is, the higher the norm will be. This is due to age-related changes in the body and a natural enlargement of the prostate.
Let’s consider in the following table how the norms of general PSA look depending on the age of a person.
|Age years||Values, ng / ml|
We offer you to find out about the norms of free PSA, which also depend on the age of the patient.
|Age years||Values, ng / ml|
|Until 40||Until 0,5|
PSA blood test what is it? PSA is a specific prostatic antigen, a protein in nature. It is formed in the tissue of the prostate gland, an organ of the male genitourinary system and serves as an important component of male sperm. In a man who does not have health problems in this part, the bulk of the synthesized antigen enters the ejaculate. In the blood, its content in the free and bound fraction is scanty.
The level of prostate-specific antigen in the blood rises with benign and malignant diseases of the prostate gland, which is used as a tumor marker.
General and free
PSA general = loose bound
The ratio of bound and free form is about 9 to 1. PSA levels increase in both benign and malignant diseases of the prostate gland. In the initial stages of prostate carcinoma (cancer), there may be a slight increase in this parameter, but the proportion of the bound fraction increases more, so the ratio between free and total PSA decreases.
|The ratio of free PSA to total (%)||Carcinoma prognosis|
|less than 15%||unfavorable prognosis|
Specific figures in different diagnostic laboratories may vary.
If the prognosis is poor, the doctor prescribes a biopsy and ultrasound of the prostate to confirm or exclude the diagnosis.
The average norm for men is 4 ng / ml.
|Возрастная группа||PSA norm (ng / ml)|
|Возрастная группа||PSA norm (ng / ml)|
|After 60 years||4|
|Возрастная группа||PSA norm (ng / ml)|
|After 65 years||4,5|
A blood test for PSA will depend on age and general health. A norm of 4 ng / ml is considered common for all ages, but for men under 40 years old, the result should be slightly lower, about 2,5-3,5 ng / ml. In people over 60, a result of 4,5-5,5 ng / mg can also be considered normal.
An elevated PSA level is not an absolute confirmation of the presence of cancerous processes. Often this is due to inflammation or adenoma of the prostate.
However, a strongly expressed and stably high amount of antigens in the blood most likely indicates a malignant process in the prostate.
When interpreting the result, the doctor will be guided by such indicators as:
- age of the patient;
- concentration density of antigens;
- level of speed of their increase;
- PSA ratio of coherent and free.
Basically, a PSA blood test is used as a tumor marker, but there are other situations where controlling the level of antigens can be useful.
If prostate cancer is not in doubt, the analysis will help determine how the disease has progressed, to keep under control the course of treatment and its effectiveness. To compare the results, the analysis is repeated every three months.
After surgery to remove cancer in the prostate and postoperative therapy, the PSA level should normalize. If this does not happen, then a relapse has occurred, and the disease is progressing again.
The problem of a malignant tumor in the prostate is more relevant than ever, as the increase in morbidity and mortality is steadily increasing. A PSA blood test will help determine the disease at an early stage when the disease is best treated. The whole procedure will cost you about 500 rubles.
Have you had a full examination of doctors in the last 5 years?
PSA analysis is prescribed when:
- The doctor suspected prostate carcinoma during examination.
- The treatment of existing cancer of the gland in the patient is carried out (allows you to track the aggressiveness of cancer cells in the prostate and evaluate the effectiveness of the treatment).
- Previously, the patient underwent radical antitumor therapy for prostate cancer. An analysis is done with the aim of early detection of relapse every 3-4 months.
- Men over 40 years of age – it is recommended that the analysis be performed at least 1 time per year in preventive measures (due to age-related changes in the prostate – it becomes larger and the risk of developing pathologies increases).
PSA blood test: deciphering what it is, general PSA, preparation and norm
If the PSA rises, this usually indicates the development of a prostate tumor. And the higher this indicator is, the later the stage of cancer development in the patient and the higher the probability of the spread of metastases. The rate of total PSA is an indicator not higher than 4,0 ng / ml. If the decoding PSA showed a slight increase in the level of antigen, then the doctor will prescribe an additional examination:
- A blood test to determine the level of white blood cells and ESR.
- Analysis of total and free PSA with the calculation of the ratio of their ratio.
- PSA density calculation is the ratio between the amount of antigen and the size of the prostate, which can be determined by ultrasound. A low level indicates hyperplasia, and a high one indicates a malignant formation.
- The calculation of the rate of increase in the amount of antigen for a certain period of time. The greater the increase in concentration during the year, the greater the likelihood of developing oncology.
Use of digital rectal examination (PRI) and PSA in the diagnosis of prostate diseases
As an additional study, a biopsy can be performed, the indication for which is an increased level of PSA.
A PSA blood test is performed not only to determine a malignant tumor, but also to monitor the effectiveness of therapy:
- PSA after radical prostatectomy is sharply and permanently reduced.
- After undergoing chemo- or radiation therapy, the PSA level decreases at a slow pace. If this indicator decreases by 1 ng / ml or more, then the doctor can predict long-term remission.
- If after treatment, the antigen level has increased again, this indicates a relapse of the disease.
To correctly interpret the results, urologists take into account the age of the patient.
After blood sampling for the study of PSA, the decoding of the results of the study is carried out during the day. The data obtained are compared with norm indicators, which may differ for different age groups. Tests for total and free PSA also have certain differences, which should be familiarized in advance.
Most often, blood is examined by the immunochemiluminescent method (IHLA), the most advanced laboratory diagnostic option. Its basis is represented by an immunological reaction aimed at identifying PSA protein elements using phosphors – substances that glow under the influence of ultraviolet radiation.
Protein values above 4 ng / ml, but less than 10 may indicate the presence of prostatitis or benign neoplasms of the prostate, such as organ adenomas, or the onset of pre-cancerous mutations in the gland tissues. In this case, the patient needs additional diagnostic tests. If the tumor markers are more than 10 ng / ml, this fact with a high probability indicates the presence of an oncological process, and in case of exceeding the PSA values from 50 ng / ml – the spread of metastases in the body.
Decreased PSA values indicate that the patient is healthy or an effective course of treatment has been selected for him and the tumor in the prostate gland has now been eradicated.
The study of tumor markers
There are cases when prostate pathologies occur against the background of chronic pancreatitis. With inflammation in the pancreas, toxins form, which adversely affect the state of the organs of the male genital area. Therefore, together with a PSA test, a blood test for CA 242 is often prescribed. This protein also belongs to tumor markers. Its increase is noted in diseases of the pancreas.
Reference values of the marker CA 242 in the blood are from 0 to 3 IU / ml. Its increase may indicate the following pathologies:
- Up to 10 IU – acute and chronic pancreatitis;
- 20-30 IU – benign pancreatic hyperplasia;
- more than 30 IU – pancreatic cancer.
If the patient exceeds the normal tumor markers CA 242 and PSA, then this indicates the pancreatic origin of prostate diseases. It is important to remember that many pathologies of the pancreas can occur without severe symptoms. Analysis of the tumor marker allows you to identify such diseases at the initial stage.
The scheme for studying tumor markers for PSA is general and PSA free will be as follows:
- Diagnosis of prostate tumors after conducting digital and other organ tests.
- Monitoring the cancer process and evaluating the effectiveness of the therapy.
- Preventive examination for men over 40 years of age.
The analysis is necessarily prescribed to persons who have already undergone radical treatment of prostate carcinoma. In this case, the study is carried out every 3 months so that the doctor has the opportunity to dynamically assess the patient’s condition and in time to identify a possible relapse of the disease.
PSA increase rate
The growth rate of antigen over a certain period of time also matters, PSA analysis will also help control this indicator. The rate of antigen increase is 0,76 nanograms per year.
The fact is that in the presence of cancer cells in the prostate, PSA in the blood can not always be high, so it is important to monitor the level of concentration of substances. If a man had previously taken a PSA test, his norm was 2,5 ng / ml, and after a year the antigen concentration increased to 3,5 ng / ml, this fact cannot be ignored. Over the year, the level increased by more than 0,76 nanograms, which means that an additional examination is required.
An increase in PSA may indicate the following pathologies:
- hyperplasia (adenoma) of the prostate;
- malignant tumors of the prostate gland;
- ischemia or heart attack of the prostate.
Significant excess of reference values PSA observed in prostate cancer. In the presence of malignant tumors, the following analysis results are possible:
- 4-10 ng / ml. In this case, the doctor only suspects cancer in the patient. To confirm or refute the diagnosis, additional studies are necessary.
- 10-20 ng / ml. Such an indicator indicates a high probability of cancer.
- More than 40 ng / ml. Very high PSA is most often seen in metastatic prostate cancer. As an additional diagnosis, the patient is prescribed a prostate biopsy.
PSA analysis: what it is, why and how to take these tests, preparation for passing a blood test for a dog, norm, decoding of results
Analysis results for PSA in some cases can be false negative or false positive. For example, an antigen titer will be higher or lower than normal if the patient has been taking certain medications for a long time during therapy. In particular, the use of Finasteride and Dutasteride medicines leads to a decrease in free PSA, against which the results of the study should not be considered reliable. Sexual intercourse, palpation and massage of the prostate can also affect the level of total PSA.
Therefore, careful preparation for it is important before passing the analysis, which ensures the reliability of the study. Possessing its exact results, the doctor will be able to choose the most effective treatment.
To determine the level of PSA, the patient takes blood from a vein in the morning on an empty stomach. The study of both types of tumor marker (total and free) is carried out from one portion of the taken biological material. Evaluation of analysis indicators should be comprehensive. The result is interpreted solely by the doctor.
A blood test for tumor markers today can be taken on the day of treatment at any commercial clinic or laboratory. In these medical institutions you can get results in a fairly short period of time. Consider where you can go:
- Medical laboratory “Invivo”, Moscow, st. 1st Communist, d. 31. Cost 450 rubles.
- Diagnostic and treatment center “Clinic of Modern Medicine”, Moscow, st. Victory, d. 2, building. 1. The price is 800 rubles.
- Medical Clinic “ArsVita”, St. Petersburg, ul. Krasnoputilovskaya, d. 125. The cost of 980 rubles.
- Clinic of Professor Fedoseyev “Allergomed”, St. Petersburg, Moscow Avenue, 109, 3rd floor. Price 400 rub.
In the regions of Russia, research on prostatic antigen can be carried out in large laboratories such as Invitro. They are in almost every city. In addition to the test for determining the PSA titer, they can be tested for male and female sex hormones, enzymes, in particular creatinine, other tumor markers, such as AFP, and much more.
There are cases when in healthy men the concentration of PSA in the blood significantly exceeds the permissible norm. The prostate cancer marker may be elevated in the following cases:
- in violation of the rules of preparation for the study (the use of fatty foods, alcohol, sexual intercourse shortly before analysis);
- when taking vitamin complexes with ascorbic acid;
- during chemotherapy;
- with the use of 5-alpha-reductase inhibitors (for example, “Finasteride”);
- after exposure to the prostate during diagnostic procedures or organ massage;
- after a biopsy of the prostate.
In case of violation of the rules for preparing for the test, doctors recommend excluding medication and retake the analysis.
On average, the results of the study are ready by the end of the first day from the moment of taking blood for analysis. Less commonly, dough production times are from 2 to 10 days.
If PSA is elevated
What to do if a man exceeds the PSA tumor marker above normal? The interpretation and decoding of the test results can only be done by a urologist. Experts do not make the final diagnosis of only one test for the prostatic antigen. If the indicators deviate from the norm, the patient is prescribed the following additional examinations:
- General blood analysis. An increase in the number of leukocytes and the level of ESR indicates inflammatory pathologies.
- Prostate biopsy. With a thin needle, the doctor takes a piece of gland tissue for examination. This allows you to determine the type of neoplasm.
- MRI or CT scan of the prostate. This study helps to identify the magnitude and extent of tumor spread.
Only on the basis of data from a comprehensive examination, the doctor can make an accurate diagnosis and prescribe the necessary treatment.
Prostate cancer in the initial stages is treated with hormonal drugs. In many cases, this helps to stop the growth of the tumor. In advanced cases, the tumor is removed surgically and a course of chemotherapy is prescribed.
Nowadays, there is a new method of treating prostate tumors – virotherapy. Special viruses are introduced into the patient’s body. They do not harm human health, but at the same time destroy cancer cells. In addition, drugs with viruses activate the immune system to fight the tumor.
Often men are interested in the question: “How to lower PSA?” It is important to remember that there are no special drugs that reduce the production of this protein. It is necessary to deal with the treatment of the underlying disease. Only after passing a course of drug therapy or surgical removal of the tumor does the PSA level normalize.