Urinary PSA in monitoring of patients with prostate cancer

To estimate the value of urinary prostate specific antigen (uPSA) determination in the monitoring of prostate cancer (PCa) patients.

From January 2001 to December 2011, uPSA was determined in 397 patients. There were 265 patients with benign prostate, 19 with prostatitis and 113 with prostate cancer. Radical retropubic prostatectomy (RRP) was performed at 65 patients, while 48 patients had PCa received antiandrogen therapy.

Average uPSA value in the patients with benign prostate hyperplasia (BPH) was 190.8 +/- 184.2 ng/mL. Average uPSA in the patients with PCa was 287.5 +/- 303.4 ng/ml and it was not significantly different from BPH group. The average uPSA in the prostatitis group was 113.1 +/- 148.5 ng/mL, and 16.4 +/- 36.7 ng/mL in the post RRP group. During antiandrogen therapy, uPSA and PSA correlated significantly (r = 0.49).

The uPSA level reflects the response of normal prostatic and urethral secretory cells on total androgen activity. The uPSA level cannot distinguish the cases with BPH and cases with PCa. In addition, in the patients after RRP, uPSA reflects local urethral PSA production and has no role in the diagnosis of PCa recurrence. However, uPSA is better indicator of androgen suppression than testosterone (T), as it reflects the effect of suppression of all androgens, not only T.