IMPLICATION OF PROSTATE SPECIFIC ANTIGEN IN BENIGN PROSTATIC HYPERPLASIA


Singh SK , Prabhu GGL

ABSTRACT
Background: Prostate-specific antigen (PSA) is the prostatic tumour marker of choice. Because PSA is not prostate cancer specific and prostate cancer develops in man at an age when the prevalence of benign prostatic hyperplasia is high, several parameters have been developed and investigated to enhance the sensitivity and specificity of the PSA test. The parameters included are PSA density (serum PSA concentration divided by the size of the prostate gland), PSA velocity (change in serum PSA over time), age specific reference ranges for serum PSA, percent free PSA, Digital rectal examination.
Aim and Objectives: The aim of this study is to find out the implication of prostate specific antigen in benign prostatic hyperplasia.
Materials and Methods: In this research, a correlative study of total serum PSA with digital rectal examination, prostatic volume, Transabdominal Ultrasonography, urine analysis with culture and sensitivity and histopathological examination of the patients with prostatic hyperplasia was done in 100 patients.
 Here our exclusion criterion was the patients with carcinoma of prostate. PSA was estimated in fasting blood sample and was collected when patient is without Foleys catheter or with catheter (24 hours after catheterization). It was estimated by Ciba Corning Automated Chemiluminescence System (ACS) using both monoclonal and polyclonal anti-PSA antibody titers. 
Results and conclusion: Age specific rise in Serum prostate specific antigen level was found. The prostatic volume was highly significant in correlation with Serum prostate specific antigen. Digital Rectal Examination when compared with other parameters was found not to be significant in predicting the prostatic disease. 
The Total Serum PSA level done in all the cases does not show significance and none of the patients had malignancy even with Serum PSA> 4ng/ml. When prostate specific antigen density was calculated and compared with biopsy report positively, it was significant and was helpful in predicting the prostatic diseases and prognosis. With this we conclude that clinical correlation with Digital Rectal Examination and Transabdominal Ultrasound is very much helpful in predicting malignancy than totally relying on Serum PSA. We found that PSA is neither organ specific chemical nor disease specific. 

Keywords: Benign prostatic hyperplasia, Transabdominal ultrasonography, Total Serum PSA, Digital rectal examination