Quantification of prostatic cancer metastatic disease using prostate-specific antigen

Area of Science:

• Urology
• Oncology
• Biochemistry

Background:

• Serum prostate-specific antigen (PSA) is a key biomarker for prostate health.
• Elevated PSA levels can indicate benign prostatic hypertrophy (BPH) or prostate cancer (CaP).
• Standard PSA measurements may be influenced by prostate size.

Purpose of the Study:

• To investigate the correlation between serum PSA and resected prostate tissue weight.
• To develop and validate a PSA-to-prostate weight index for improved diagnostic accuracy.
• To assess the index's ability to differentiate between BPH, localized CaP, and metastatic CaP.

Main Methods:

• Correlation analysis between serum PSA and resected prostate weight in men undergoing transurethral prostatectomy (TURP).
• Calculation of a novel index by dividing serum PSA by prostate weight.
• Comparison of PSA index values across normal controls, BPH patients, and CaP patients (localized and metastatic).

Main Results:

• A significant correlation was found between serum PSA and resected tissue weight in BPH patients (p ≤ 0.001; r = 0.54).
• No significant correlation was observed between serum PSA and resected tissue weight in CaP patients.
• The novel PSA index did not differ significantly between normal controls and BPH patients.
• The PSA index was significantly higher in CaP patients compared to controls and BPH patients (p ≤ 0.001).
• The PSA index was significantly higher in metastatic CaP (M1) than in non-metastatic CaP (M0) (p = 0.05).

Conclusions:

• The PSA-to-prostate weight index offers improved differentiation between benign and malignant prostate conditions.
• This index may serve as a valuable tool for estimating local and metastatic tumor burden in prostate cancer.
• Further research is warranted to establish the clinical utility of the PSA index in prostate cancer management.