[PSA in prostatic fluid]

Correct forecasting of prostatic carcinoma by means of serum PSA is limited. Prostatic carcinoma is said to increase PSA 10 times as much as prostatic adenoma. Therefore we evaluated whether PSA in the prostatic fluid is more specific for prostatic carcinoma than the level in the serum. In 31 consecutive patients with prostatic disease blood was taken for serum PSA first and then prostatic fluid (10 microliters) was expressed. The PSA was determined by the Pros-Check test in both the serum and in the prostatic fluid. The collection of the prostatic fluid failed in 7 (22.6%) patients. Of the remaining 24 patients, 5 had documented bacterial prostatitis, 4 had prostatic carcinoma and 15 had benign prostatic hyperplasia (BPH). The serum PSA was 5.6 +/- 5.0 micrograms/l in prostatitis, 148 +/- 208 micrograms/l in prostatic carcinoma and 6.9 +/- 6.8 micrograms/l in BPH. The serum PSA was significantly higher in prostatic cancer (P < or = 0.01) than in prostatitis and BPH. The PSA levels in the prostatic fluid were 14.0 +/- 25.7 x 10(6) micrograms/l in prostatitis, 7.6 +/- 9.7 x 10(6) micrograms/l in carcinoma and 14.0 +/- 14.6 x 10(6) micrograms/l in BPH. There were no statistically significant differences. In the expressed prostatic fluid no significantly different PSA was found in carcinoma, bacterial prostatitis or BPH. In contrast to this, the serum PSA was significantly higher in cancer patients than in prostatitis or BPH. Therefore PSA in the expressed prostatic fluid is no more specific than that in the serum.(ABSTRACT TRUNCATED AT 250 WORDS)