What will help establish the PSA oncomarker: the norm. Analysis of the PSA tumor marker - especially for the prostate Psa prostate tumor marker is the norm

Nowadays, there are a huge number of diseases that are difficult to identify, especially at the time of development. Oncology refers to one of the types of such diseases. The problem of researching cancerous tumors exists in almost every country in the world, and, unfortunately, the number of cancer patients is only increasing every year. If you detect a problem at an early stage, then. If you suspect prostate cancer, you should donate blood for the PSA tumor marker. In the case of early detection of the disease, it will be possible to avoid metastasis, as well as to do without long-term relapses.

What can affect the development of a tumor in men

• cancer of the liver;
• lungs;
• kidneys;
• Bladder;
• lymph nodes;
• for skin cancer;
• brain tumor;
• cancer cells in the throat;
• tumor marker PSA for men.

If you are going to do a blood test, then it is advisable to follow some tips.

1. It is necessary to carry out blood sampling for PSA oncomarker only on an empty stomach. At least 12 hours after the previous meal.
2. If it is necessary to examine the PSA oncomarker of the prostate, a week before the delivery, you should refrain from sexual intercourse, and also not have any effect on the prostate gland and not conduct its examination.
3. You should definitely not smoke on the day of blood sampling. Nicotine to have a negative impact on the outcome of studies.
4. Be sure to monitor your diet before conducting a blood test for antigens. You should not eat spicy, fatty, salty fried foods for three days. It is advisable to follow a diet in general.
5. If possible, a few days before the PSA oncomarker test, do not take any drugs.
6. It is best to take blood before 11 am. Since all the norms that are indicated describe the indicators obtained from 7.00 to 11.00.
7. For several days, do not burden yourself with any physical exercises.
8. Before you go to donate blood to the laboratory for tumor markers, it is advisable to rest for 20-25 minutes in order to calm the nervous system.
9. If, seven days before the delivery of the material for the study, ultrasound and other examinations were performed, be sure to tell your doctor about this.
10. It is not recommended to drink alcohol three days before the test.

Remember these tips and always stick to them in order to get more accurate research results. Also, for the accuracy of research on the PSA oncomarker, it is advisable to always take tests exclusively at one medical office.

Why do you need a PSA blood test?

What does the PSA tumor marker show? This is a special type of study (prostate specific psa). A tumor marker that can detect proteins in the blood that are produced by the prostate gland. It is thanks to this method of examination that cancer can be detected at an early stage. The doctor will be able to prescribe treatment in time.

The PSA tumor marker is usually prescribed if there is even the slightest suspicion of a tumor. Basically, it is necessary to pass the analysis:

• with suspected prostate cancer;
• if inflammation of the prostate occurs;
• in case of appearance of benign formations;
• with suspicion of ischemia;
• to monitor the effectiveness of treatment.

And also for prevention, it is recommended to take an analysis for the general PSA oncomarker every year. The analysis itself is performed in this way: blood is drawn from a vein into a container, the puncture site is sterilized. If a hematoma appears at the site of blood sampling, then a warm compress should be applied.

On average, the norm is from 0.2 - 4 ng / ml. The norm of indicators depends mainly only on the age of the patient:

Attention! There are cases when the indicators deviate from a certain norm, which indicates only a malfunction of some organ or indicates the presence of a benign tumor. Also, with various viral diseases, you can get a false result. Therefore, before drawing any conclusions, consult a doctor.

After receiving the result of the analysis, the doctor must prescribe a course of treatment. The exact result is not determined by analysis only in the case of:

• if there is a suspicion of prostate cancer;
• if there is a possibility of hyperplasia. In this case, an additional examination is required;
• if suddenly tumor markers showed more than 40, then we will talk about the presence of metastases. Another examination will help you learn about the treatment of prostate adenoma and what measures and drugs should be taken to alleviate the condition.

Differences between total and free PSA

The general analysis differs from the free one only in that it is 90%, but the free one is the remaining 10%. The general marker is closely related to proteins, free PSA has nothing to do with them at all. They are connected only by the PSA marker, both are taken into account during the examination.

In order for the results of the analyzes to always please, be sure to undergo an annual examination. Take this as your rule. Be sure to eat right, observe the hygiene of the genitals, do not neglect the treatment of various infectious diseases. Do not forget also about protection during sexual intercourse (in case of a change of partner), do not hesitate to consult a doctor. Doctors are always on guard of our health.

Prostate - the prostate gland is an organ of the male reproductive system. It is involved in the production of seminal fluid and in the process of urination. Organ pathologies lead to impotence and infertility. Every third man over 30 years of age meets with certain diseases of the prostate gland. And every seventh over 50 - with prostate cancer. The disease is difficult to cure, so timely diagnosis is very important. The main way to detect a tumor at an early stage is an analysis for PSA (PSA) - a specific prostate antigen - a quantitative increase in which in the blood serum is the first bell and an indication for a deeper diagnosis by hardware methods.

Prostate cancer is the second most common cancer affecting males. The disease is amenable to surgical and medical treatment, but despite this, it has a high mortality rate. A number of factors contribute to this:

• the tumor develops slowly, over several years;
• there are no obvious clinical symptoms until the lesion reaches a certain size;
• gives early multiple metastases;
• not determined visually and by ultrasound.

The ultrasound machine will only show that there are inflammations and modifications of the organ, but does not state the presence of a tumor. A more accurate diagnosis will be shown by a biopsy or fluoroscopy, which, for preventive purposes, does more harm to the body than benefit.

However, like other types of tumors, prostate carcinoma has its own tumor markers - certain signs, the change of which indicates a pathological process. In prostate carcinoma, this is PSA.

Prostate specific antigen is a glycosylated protein produced by the surface cells of the organ. Its main purpose is to thin the seminal fluid. In addition to sperm, the substance is part of the blood serum, where it binds to other proteins (bound PSA) or exists unchanged (free PSA). The analysis, called PSA total, shows the total amount of antigen in 1 ml of material.

Even a small tumor in the initial stage increases the production of the substance, and this makes it possible to detect cancer in the early period. The amount of antigen that exceeds the permissible norm does not indicate the presence of carcinoma, but is a direct indication for deep diagnosis. The value within the age norm for 99% confirms the health of a man.

Indications for analysis

Blood sampling to determine the total amount of PSA is carried out in any clinical laboratory in the direction of a urologist or oncologist. The reason for the analysis can be both a routine check and the presence of signs of prostate disease.

In order to prevent tumor formations of the prostate, it is recommended to donate blood for PSA to men over 35 years old - once a year, over 50 years old - once every six months.

Direct indications for analysis:

• there are signs of diseases of the genitourinary system (difficult / frequent urination, pain, discharge, decreased potency and erectile function);
• change in the size of the prostate, revealed during the examination;
• the presence of a tumor in blood relatives;
• monitoring the effectiveness of the treatment of diagnosed adenoma or carcinoma of the prostate.

Blood for analysis is taken from a vein. The procedure is quick and almost painless, does not require hospitalization and issuance of a disability certificate.

Preparation for the procedure

For more accurate readings and the elimination of false positive results, patient preparation is required:

1. Within a month before the procedure, do not perform a biopsy of the prostate, do not take antibacterial drugs.
2. A week before the test, sexual rest, avoiding direct effects on the gland (massage, physical activity with pressure on the perineum, ultrasound, cystoscopy, colonoscopy).
3. For 48 hours, exclude the intake of alcoholic beverages and fatty foods.
4. Before the procedure, do not smoke (at least an hour), be calm.

It is advisable to stop eating 3 hours before blood sampling, if this is not possible, the snack should be light, non-greasy.

The antigen produced by the prostate is present in the blood serum and against the background of the full health of a man. It is known that with age, the size of the prostate gland increases, in connection with this, the level of protein also increases.

So, the quantitative norm of total PSA up to 40 years is the value - 1.4 ng / ml, and after 70 - 6.5 ng / ml. The level of 4 ng / ml is considered the average indicator of the norm, but it should be remembered that such a value in a young man can be a sign of pathology.

An increase in the level of total PSA to 10 ng / ml serves as a signal for a detailed diagnosis, over - in 50% of cases, the change is caused by an oncological process.

Deciphering the results

Even with an increase in the level of antigen to the level of 3–4 ng / ml, additional diagnostics are required, such as ultrasound or x-ray examination.

A level of 4 to 10 ng / ml indicates the presence of a neoplasm, an additional examination of the patient will show whether the tumor is benign (adenoma) or cancerous (carcinoma). A more accurate criterion in this situation would be the ratio of free PSA to total.

An increase in the number of antigen up to 20 ng / ml with a high probability (50%) indicates a malignant neoplasm, which can already metastasize to the nearest organs. Therefore, after confirming the diagnosis by prostate biopsy, a complete examination and search for other lesions is indicated.

Exceeding the norm by 4-5 times does not mean the presence of a fatal diagnosis. Such a result may be false positive, caused by infections of the prostate or a large adenoma.

The amount of antigen exceeding 30 ng / ml is extremely rarely provoked by mechanical irritation of the prostate before blood sampling, as well as inflammatory or benign processes. A comprehensive examination of the body and the identification of metastases are required. If the indicators exceed 40 ng / ml, this can only speak of 3-4 stages of cancer, which there is practically no chance of curing.

Percentage of antigen

In order to distinguish carcinoma from hyperplasia or inflammation, the amount of free prostate antigen to the total volume is calculated. Normally, this figure is approximately 10-15%.

Adenoma provokes the growth of protein in the free fraction, while carcinoma, on the contrary, increases the concentration of the bound protein.

Thus, with a result of more than 15%, there is reason to believe that the overall increase in PSA is not associated with cancer. With a decrease in the indicator relative to the norm, there is a high risk of developing a cancerous tumor.

In some cases, an increase in the amount of PSA is also recorded against the background of a man’s complete health. The reason for this is:

• mechanical irritation of the gland 72 hours before blood sampling (cycling, prostate massage, rectal palpation or ultrasound);
• sexual intercourse, masturbation, uncontrolled ejaculation three days before the analysis (sexual rest is recommended for a week before the procedure):
• prolonged urinary retention immediately before the procedure;
• installation of a urinary catheter 3 days before the analysis.

If such circumstances could affect the result, tell the doctor about it.

In addition to the tumor, an increase in the antigen in the blood is caused by inflammatory processes in the prostate gland, STDs, hormonal disorders, and strong emotionality during the procedure.

You should not panic if you find high values ​​in the analysis results. The PSA level is only one of the factors that can indicate the oncological process. A biopsy will provide an accurate diagnosis.

PSA change during therapy

• from 2 to 4 ng / ml - the percentage of probability of carcinoma - 18%;
• from 4 to 6 ng / ml - 21%;
• from 6 to 8 ng / ml - 28%;
• from 8 to 10 ng / ml - 32%;
• more than 10 ng / ml - 56%.

Above 20 ng / ml, the chances of a false positive result are negligible.

Quantitative analysis of the antigen also shows the approximate stage of tumor development. If the PSA data is confirmed by a biopsy, with a high percentage of probability:

1. Up to 10 ng / ml indicate the beginning of the development of the tumor process. Special symptoms of the disease may not be felt, since the growth of carcinoma cells is insignificant. Enlargement of the gland is not palpable, not determined by ultrasound. Accurate confirmation is given only by a biopsy of a part of the prostate gland.
2. The content of the antigen in an amount not exceeding 20 ng/ml means that the tumor has reached the second stage. It is palpable during rectal examination, and is noticeable on an ultrasound machine, but is located within the gland (it is extremely rare at this stage there are metastases in neighboring organs).
3. A further increase in the PSA value indicates the spread of cancer outside the prostate. A value above 40 ng / ml indicates the fourth, last stage, which has spread metastases to the lymphatic system of the whole body.

As long as the tumor has not gone beyond the gland, successful treatment and complete recovery are possible. With the appearance of the first metastases, the chances of getting rid of carcinoma are reduced. Therefore, it is especially important to identify the tumor at the very beginning of its growth.

With a positive effect of therapy on prostate diseases in men, the PSA value gradually decreases and returns to normal. It is important to control the growth of antigen in the blood 2-3 times a year. If a sharp jump is noticed, malignancy of hyperplasia is possible. A slight increase in the amount of PSA is the norm for this disease.

An indicator of successful treatment of carcinoma by radiation / chemotherapy or partial resection of the gland and the achievement of a state of stable remission is the result of an analysis that is close to normal. With the complete removal of the organ, the amount of antigen in the blood gradually disappears and subsequently does not exceed 0.2 ng/ml.

To test the effectiveness of treatment, blood sampling for PSA is carried out every 3 months, but not earlier than 30 days after prostate resection.

The decrease in antigen and the restoration of the normal functioning of the gland takes 2-3 years. All this time, the indicators should decrease.

A repeated increase in PSA indicates the emergence of a new focus of inflammation and requires the resumption of therapy. Even complete removal of the prostate does not guarantee getting rid of carcinoma.

Additional testing for high PSA

As already noted, an elevated level of prostate antigen does not diagnose cancer, but is only a sign of its presence. Only a biopsy is able to determine the type of tumor and the stage of its development with 100% probability. The material taken from several areas of the gland is examined in detail for the presence of cancer cells and the degree of their growth.

Biopsy is a traumatic process, unsafe for the organ. An increase in the number of PSA is not a direct indication for its implementation. To begin with, the doctor will prescribe a diagnosis to the patient using:

• palpation;
• Ultrasound with rectal probe;
• MRI or radiography, in the absence of equipment for tomography.

If there are several indicators of the development of carcinoma, the material is taken for a biopsy. The procedure takes place under general or local anesthesia, usually does not require hospitalization of the patient.

If the biopsy result is positive, then a contrast computed tomography of the whole body or a gamma image is indicated to detect tumor metastasis and choose a course of treatment.

Efficacy is monitored by repeating the PSA test and biopsy.

Cases of prostate cancer are on the rise these days. If earlier this disease was noted mostly in older men, now a dangerous pathology is also observed in young patients. A blood test for the oncomarker PSA is one of the early methods for diagnosing prostate cancer. This analysis allows you to identify the initial stages of the tumor. How is this test done? And how to decipher its results? We will consider these questions in the article.

What it is?

The tumor marker PSA (prostate specific antigen) is a protein that is produced by prostate cells. This substance liquefies the secretion of the seminal glands and is excreted along with the ejaculate.

With pathological changes in the prostate gland, the cells of the organ begin to produce PSA in increased quantities. The protein level also increases with mechanical action on the prostate gland, for example, during diagnostic procedures or organ massage.

General and free fraction

In medicine, it is customary to isolate the free and common tumor marker PSA. What is the difference? In plasma, 2 types of prostate specific antigen can be detected:

• associated with blood serum proteins (trypsins and globulins);
• unbound to blood proteins (free).

Total PSA is the sum of bound and unbound antigens. For diagnosis, the indicator of both the total and free fractions is important.

Indications for analysis

A blood test for the PSA marker is most often prescribed by urologists to detect malignant tumors in the prostate gland. However, prostate cancer is not the only indication for testing for a specific tumor marker. This study must be done if you suspect the following diseases:

• prostatitis;
• prostate adenoma;
• prostate cancer.

Also, the analysis is prescribed to men after the end of the course of treatment for prostate diseases. This allows you to control the dynamics of pathology and the effectiveness of therapy.

In order to prevent malignant tumors, a prostate antigen test is recommended for all men over 45 years of age. Middle-aged and elderly patients are at risk for oncological pathologies. PSA can be used to determine a man's propensity to develop prostate cancer.

Study preparation

In order for a blood test for PSA to give reliable results, you need to prepare in advance for the study. Before taking a sample, the following recommendations of doctors must be observed:

1. Approximately 3-4 days before the analysis, you need to stop eating fatty foods.
2. A few days before taking blood, you must refrain from alcohol. You can not even drink light alcoholic beverages. This rule is very important. Ethanol can cause a false increase in PSA.
3. Before the examination, you need to refuse to visit the gym and any physical activity. It is especially not recommended to ride a bike on the eve of the study, this leads to stimulation of the prostate and increased production of a tumor marker.
4. No food should be eaten 8 hours before the test. You can only drink clean water.
5. 2 days before the study, you need to refrain from sexual intercourse.
6. 24 hours before the analysis, any effect on the prostate should be excluded: massage, diagnostic procedures, palpation. Such manipulations increase blood circulation in the gland and lead to a false increase in PSA.
7. The day before the analysis, you should stop eating sweets and sugar.

In addition, 7 days before the analysis, you need to stop taking medication. If this is not possible, then you need to tell your doctor about all the drugs you are taking.

How the test is done

For research take blood from a vein. The PSA test is taken in the morning on an empty stomach. The biomaterial is sent to the laboratory.

To determine the prostate specific antigen, the following methods are used:

• enzyme immunoassay;
• immunochemiluminescent;
• radioimmune.

The blood serum is processed in a centrifuge, and then the analysis indicators are calculated using a photometer.

Norm

The norms of the PSA tumor marker depend on the age of the man. The older the person, the higher the antigen content in his blood. The table below shows the allowable total PSA values ​​for patients of different age categories:

If the total PSA is lowered, then this is considered a variant of the norm and is not a sign of any disease.

The index 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 for the oncomarker PSA in men. In the transcript of the analysis, the ratio between the free and total fractions is also indicated as a percentage. According to this indicator, one can judge the prognosis of the disease.

Reasons for the increase

An increase in PSA levels may indicate the following pathologies:

• prostatitis;
• hyperplasia (adenoma) of the prostate;
• malignant tumors of the prostate;
• ischemia or infarction of the prostate.

A significant excess of the reference PSA values ​​is observed in prostate cancer. In the presence of malignant tumors, the following analysis results are possible:

1. 4-10 ng/ml. In this case, the doctor only suspects the patient has cancer. Additional studies are needed to confirm or refute the diagnosis.
2. 10-20 ng/ml. This indicator indicates a high probability of cancer.
3. More than 40 ng / ml. A very high PSA is most often seen in metastatic prostate cancer. As an additional diagnosis, the patient is prescribed a biopsy of the prostate.

Free PSA values

It is important to determine not only total, but also free PSA. If the rate of unbound protein exceeds the norm, then this most often indicates benign tumors of the prostate.

As already mentioned, with prostate cancer, there is a high level of total PSA. In oncological diseases, 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.

The ratio of total and free antigen

In deciphering the analysis for a tumor marker, the ratio of the total and free fractions in percent must be indicated. To calculate it, you need to divide the free PSA value by the total PSA value, and then multiply by 100. This ratio helps doctors predict the outcome of the disease:

1. If the ratio is from 15 to 100%, then this indicates a positive prognosis.
2. A rate below 15% indicates a possible adverse outcome of cancer.

False results

There are cases when in healthy men the concentration of PSA in the blood significantly exceeds the permissible norm. The prostate tumor marker may be elevated in the following cases:

• in case of violation of the rules for preparing for the study (eating fatty foods, alcohol, sexual intercourse shortly before the analysis);
• when taking vitamin complexes with ascorbic acid;
• during chemotherapy;
• when using inhibitors of 5-alpha-reductase (for example, "Finasteride");
• after exposure to the prostate during diagnostic procedures or organ massage;
• after prostate biopsy.

If you violate the rules for preparing for the test, doctors recommend that you exclude medication and retake the test.

Oncomarker CA 242

There are cases when prostate pathologies occur against the background of chronic pancreatitis. With inflammation in the pancreas, toxins are formed that adversely affect the state of the organs of the male genital area. Therefore, along with a PSA test, a blood test for CA 242 is often prescribed. This protein also belongs to oncomarkers. Its increase is noted in diseases of the pancreas.

Reference values ​​of the CA 242 marker in the blood range 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's oncomarkers CA 242 and PSA exceed the norm, then this indicates a pancreatic origin of prostate diseases. It is important to remember that many pathologies of the pancreas can occur without severe symptoms. An analysis for a tumor marker makes it possible to identify such diseases at an early stage.

If PSA is elevated

What to do if a man's PSA tumor marker exceeds the norm? Only a urologist can interpret and decipher the test results. Specialists do not make a definitive diagnosis only on one analysis for prostate antigen. If the indicators deviate from the norm, the patient is prescribed the following additional examinations:

1. General blood analysis. An increase in the number of leukocytes and the level of ESR indicates inflammatory pathologies.
2. Biopsy of the prostate. With a thin needle, the doctor takes a piece of gland tissue for examination. This allows you to determine the type of neoplasm.
3. MRI or CT scan of the prostate. This study helps to determine the size and extent of the spread of the tumor.

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 its early stages is treated with hormonal drugs. In many cases, this helps to stop the growth of the neoplasm. In advanced cases, the tumor is removed surgically and a course of chemotherapy is prescribed.

Today there is a new method of treatment of 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 specific drugs that reduce the production of this protein. It is necessary to deal with the treatment of the underlying disease. Only after undergoing a course of drug therapy or surgical removal of the tumor, the PSA level returns to normal.

- prostate specific antigen, in its structure is a two-component protein (glycoprotein). It is secreted by the epithelial cells of the prostate gland and, as part of its juice, enters the seminal fluid. Its main function is to dilute the sperm to ensure functional sperm motility.

In the blood secrete:

• total PSA;
• free PSA;
• associated PSA.

The sum of bound and free is equal to the total PSA. The free form normally occupies about 20% of the total PSA.

Diagnostic value is mainly the total level of PSA, the value of which increases depending on the growth of the prostate.

The method is the most specific for the identification of prostate cancer. It is prescribed for existing urination disorders, especially at night (nocturia).

It is used in conjunction with a digital examination, ultrasound.

Note:determination of the PSA level is prescribed after irritation of the prostate gland by a digital examination and also after the use of rectal suppositories not earlier than a week after these procedures. Since they can distort the reliable result.

An even longer period must be maintained after:

• prostate biopsy techniques;
• removal (resection) of the prostate;
• mechanical massage.

Important: both total and free PSA must be taken and determined from one taken "portion" of blood, use one method. It is necessary to do the analysis only in one laboratory.

Blood is collected in the morning, before meals. For blood sampling, the vein of the elbow bend is used.

Rules for preparing a patient for a blood test for PSA

The last meal should be at least 12 hours before blood sampling. You can drink only plain water, no other drinks, especially those containing caffeine, should not be drunk. Alcohol is strictly contraindicated.

Two days before the study, the patient must follow a diet that excludes fried, smoked, fatty, too salty. If possible, you should refrain from meat products. Boiled vegetables, acid-neutral fruits are recommended for eating. You can cook lean vegetable soups and cereals.

For several days, it is worth refraining from doing sports, hard physical work, cycling is not recommended. It is also worth giving up sexual activity.

Total PSA is a tissue prostatic protein that is part of the contents of the excretory secreted prostate. In medicine, it is a marker of tumor diseases.

In what cases is an analysis prescribed to determine the values ​​of the total PSA:

• diagnostics ;
• control of adenoma treatment;
• diagnosis, especially detection of a tumor at an early stage;
• control over the process of treatment of an already diagnosed malignant neoplasm of the prostate gland.

In what cases are increased indicators of total PSA determined:

• at all stages of development of prostate adenoma;
• after surgery for the removal of prostate adenoma;
• after the fact of ejaculation that happened on the eve of the analysis;
• in case of problems with potency;
• with various forms of violation of the act of urination;
• after long cycling, especially on bumpy roads.

Note: if the PSA (total) values ​​exceed 30 ng / ml, then this fact should be regarded as a case of a possible developing oncological process.

In the advanced stages of cancer, with existing metastasis, total PSA levels can reach 1000 ng / ml and above.

Free Prostate Specific Antigen PSA Assay

Free prostate specific antigen is part of the total PSA and is also a product of the physiological activity of the prostate gland.

Note:the greater the age, the higher the index of this antigen.

In any case, its level should not go beyond 4 ng / ml.

The data of this marker should be determined for signs of prostate cancer.

In addition to the free PSA indicator itself, in urological and andrological practice, the determination of the percentage of free PSA to total PSA is used. The value is determined in percentage terms.

The figures of this ratio are of particular importance if the total PSA is already above the norm, but does not rise to critically dangerous values ​​and is in the range of 4.0-10.0 ng / ml.

In this case, if the ratio of free PSA/total PSA does not rise above 15%, a benign growth can be assumed. If, in the process of dynamic monitoring of the level of this indicator, its gradual increase is noted, then we can draw conclusions about the possible malignancy of the process, as well as the small effect of both conservative and surgical measures.

If, on the background of the treatment, the level of the ratio decreases, then we can draw conclusions about the beneficial effects of the treatment process.

A free PSA value of less than 0.93 ng/ml.

In what cases is the concentration of free PSA increased:

• with existing prostate adenoma at different stages of the disease;
• inflammatory and proliferative processes of prostate tissue (prostatitis);
• malignant pathology of the prostate;
• early terms of the postoperative period in the surgical treatment of the pancreas;
• ejaculation (ejaculation) a few hours before the test.

In prostate cancer, the level of free PSA is much lower than in benign hyperplastic processes and inflammatory diseases.

Prognostic value is the ratio of "PSA free / PSA total":

• if the indicator is less than 15%, then it speaks of existing serious problems, and is unfavorable in prognostic terms;
• if the indicator is in the range of 15-70%, then the prognosis is favorable.

The state of health in most cases depends on the person himself. To determine the developing malignant process in the early stages, it is necessary to periodically undergo preventive examinations.

That is why men, after reaching the age of 50, and in some cases even earlier (with an existing pathology of the prostate), it is necessary to take a PSA test at least once a year.

If you find analysis indicators that go beyond the norm, you should see an andrologist, urologist, or oncologist, and undergo a full examination for the purpose of early diagnosis of a possible disease.

Note:not in all cases when the analysis numbers go beyond the norms there is a pathological process.

Detection of a malignant disease at an early stage allows almost 100% of cases to recover from it.

You will receive more detailed information about the method of blood testing for PSA and other tumor markers, as well as the effectiveness of these tests, by watching a video review:

Lotin Alexander, medical columnist

PSA (prostate-specific antigen) is a specific protein found in the blood that is produced by prostate cells. Only a small fraction of PSA seeps into the blood. The main purpose of the PSA test is to diagnose prostate cancer at the initial stage.

The tumor marker increases if the body reacts to a tumor or under other conditions. In different diseases, there is a different degree of increase in the level of the oncomarker. An elevated PSA can be a sign of the following conditions:

• prostate cancer;
• BPH;
• prostate infections;
• insufficient blood supply to the prostate;
• prostate injury.

Men over the age of 40 are at risk of developing prostate cancer.

Therefore, the diagnosis of PSA levels should be annual.

At this age, the ideal PSA level in the blood is a maximum of 2.5 ng / mg. After 50 years, the normal value of the tumor marker is 3.5 ng/ml. If the indicator exceeded the mark of 4 ng / ml, the patient is examined in more detail.

The size of the prostate increases with human age, therefore, the PSA level increases in proportion to the volume of the prostate.

The doctor prescribes a puncture biopsy of the prostate when the indicator exceeded 10 ng / ml.

PSA analysis (PSA)

So, the established norm of the PSA oncomarker (regardless of age): 0-4 ng / ml. At the moment, the medical community is considering lowering the PSA threshold to 3 ng / mg for earlier diagnosis and prevention of oncology.

The condition of the prostate depends on the PSA value. So, there is a possibility of a false positive result in the case of:

• prostatitis;
• ischemia and infarction;
• if a day before blood donation, the prostate was affected by massage, physiotherapy, digital rectal examination, prostate biopsy. In this case, the diagnosis should be carried out only after 10-12 days.

Please note that some drugs underestimate the PSA index by half. You should be careful with them, because they mask a possible tumor. During this period, the doctor reduces the norm of the tumor marker.

If the PSA value exceeds 20 ng / mg, the possibility of a neoplasm increases, therefore the next step is a biopsy.

In order to control the effectiveness of the therapeutic effect and early detection of oncology, the level of the PSA oncomarker is monitored in the following cases:

• after prostate surgery. The oncomarker limit is 0.1 ng/ml.
• after radiation exposure to unhealthy cells. The reduction should be no less than half of the figure in the first stage.

Analysis of the PSA indicator is carried out by taking blood from a vein. The specialist may prescribe a determination of total PSA, and in some cases it is necessary to determine free PSA.

Stages of preparation for donating blood for PSA:

• Blood is donated on an empty stomach. Dinner the day before should be simple, without fatty and salty foods. Refrain from alcohol, coffee, tea, juices.
• To avoid an increase in the PSA level, refuse sexual intercourse a week before the diagnosis.
• If there was an examination by a urologist, blood is donated only after two weeks.
• After a prostate massage prescribed by a doctor or any other mechanical effect on the prostate gland, a PSA test can be taken only after 2 weeks. Did the doctor order a prostate biopsy? PSA analysis only after 30 days.