[Prostate-specific antigen. A new marker of prostatic pathology]

Prostate-specific antigen (PSA) and prostate acid phosphatase (PAP) were assayed using a radioimmunologic method in 306 patients from November 1986 through April 1987. Study patients included 10 women, 10 men under forty years of age, 25 patients with malignancies involving structures other than the prostate, and 280 patients with diseases of the prostate ie. benign hypertrophy of the prostate (BHP) (n = 170), or histologically-proved carcinoma of the prostate (CaP) (n = 110). Serum PSA levels were undetectable in women and following total prostatectomy; levels of 3 ng/ml were found in young men, with no circadian variations. Non-prostatic carcinomas had no influence on PSA levels. PSA levels in BHP patients were 6.9 +/- 8.4 ng/ml and correlated positively with the weight of the gland. In patients with carcinoma of the prostate, PSA levels were 24.4 +/- 19.3 ng/ml, correlated positively with tumor spread, and returned to normal following successful palliative hormone treatment, with new increases reflecting recurrences. PSA assays are of little value for screening for carcinoma of the prostate; however carcinoma of the prostate is found in 70% of patients with inconsiderable BHP and PSA levels above 15 ng/ml. PSA is mainly useful for monitoring patients with carcinoma of the prostate. No patient with BHP had marked elevations of PAP, whereas high PAP levels were found in 26% of patients with carcinoma of the prostate. Eighty-eight per cent of patients with carcinoma of the prostate had increased PAS levels, which were the only finding in 48 cases. No patient with carcinoma of the prostate had increased PAP levels with normal PSA levels.(ABSTRACT TRUNCATED AT 250 WORDS)