Prostate-specific antigen levels from completely sectioned, clinically benign, whole prostates.

Area of Science:

• Urology
• Pathology
• Oncology

Background:

• Prostate-specific antigen (PSA) is a key biomarker for prostate health.
• Elevated PSA levels can indicate prostate cancer (CAP), but other factors like prostate size can influence levels.
• Understanding the relationship between prostate size, CAP presence, and PSA levels is crucial for accurate diagnosis.

Purpose of the Study:

• To investigate the correlation between prostate size, the presence and volume of carcinoma of the prostate (CAP), and serum PSA levels.
• To determine if elevated PSA levels are primarily associated with CAP or prostate size.

Main Methods:

• Autopsy analysis of 105 whole, untrimmed prostates and associated pelvic lymph nodes.
• Measurement of premortem serum PSA levels for all patients.
• Categorization of patients based on the presence and volume of CAP (none, <1 ml, >1 ml) and prostate weight (≥80 g, <80 g).

Main Results:

• Prostates weighing ≥80 g (equivalent to 60g trimmed) showed elevated PSA levels irrespective of CAP presence.
• In prostates <80 g, CAP <1 ml generally did not elevate PSA, while CAP >1 ml significantly did (P < 0.0001).
• The probability of elevated PSA in <80g prostates being due to CAP >1 ml increased with higher PSA levels.

Conclusions:

• Prostate size significantly impacts PSA levels, with larger prostates (≥80g) frequently exhibiting elevated PSA.
• In smaller prostates (<80g), the volume of CAP is a critical determinant of PSA elevation.
• Elevated PSA in smaller prostates warrants further investigation for clinically significant CAP, particularly at higher PSA concentrations.