Clinical value of prostate specific antigen(PSA) as a tumor marker in prostatic adenocarcinoma

Lee, Jong Bouk; Kim, Soo Woong; Oh, Sung Joon; Chung, Jin Soo; Chung, June Key; Lee, Sang Eun

Abstract

Serum prostate specific antigen (ELSA-PSA9 monoclonal immunoradiometric assay) was determined in 43 patients with untreated prostatic adenocarcinoma as well as 36 patients with BPH. And serum prostatic acid phosphatase(Gamma Dab-r radioimmunoassay) was also measured to investigate the value as another tumor marker. Mean values of serum PSA in normal controls. patients with BPH and patients with prostatic adenocarcinoma were 2.09+/-0.16 ng/ml, 11.31+/-2.24 ng/ml and 666+/-109 ng/ml, respectively (P<0.01). Of 36 patients with BPH, 22(61%) patients showed increased values of serum PSA. The levels of PSA were increased significantly as advancement of clinical cancer stage, and statistically significant differences were noticed in PSA values between 2 groups of patients with low(Gleason sum <6) and high Gleason scroes(Gleason sum >7) (P<0.01). Marked decreases of serum PSA levels were observed in short intervals after orchiectomy in stage D prostate cancer (41% and 78% decrease of preoperative levels at 1 week and 1 month, respectively). Serum PSA levels were relatively coincident with the clinical status of the patients, and decreased to the normal range within 4 months with improvement of symptoms in 5 of 12 patients followed( from 2 to 15 months with a mean of 8 months) after anti-androgen therapy, and the average rate of decrease of PSA levels was 185 ng/ml/month. We concluded that PSA is a sensitive serum tumor marker for glandular differentiation, stagingand monitoring the response after treatment in prostatic adenocarcinoma.