Prostatic acid phosphatase levels (enzymatic method) from completely sectioned, clinically benign, whole prostates

Area of Science:

• Urology
• Pathology
• Biochemistry

Background:

• Prostate cancer (CAP) is a significant health concern.
• Prostatic acid phosphatase (PAP) is a biomarker often used in prostate cancer diagnostics.
• The correlation between PAP levels and the presence and extent of CAP requires further investigation.

Purpose of the Study:

• To determine the frequency of elevated PAP levels in prostates with and without carcinoma of the prostate (CAP).
• To identify other prostatic findings associated with elevated PAP levels.
• To assess the diagnostic utility of PAP in distinguishing CAP from benign conditions.

Main Methods:

• Autopsy examination of 104 whole, untrimmed prostates.
• Microscopic sectioning and histological analysis of all prostates.
• Correlation of gross and histological findings with premortem prostatic acid phosphatase (PAP) levels.

Main Results:

• 58% of prostates had no CAP, 33% had small CAP (<1 ml), and 10% had larger CAP (>1 ml).
• Elevated PAP levels (>1 U/L) were found in 13% of prostates without CAP, 6% with small CAP, and 10% with larger CAP.
• A significant correlation was found between PAP levels and prostate weight (p < 0.0001), but not with age, race, inflammation, or prostatic intraepithelial neoplasia (PIN).

Conclusions:

• PAP levels cannot reliably distinguish between patients with and without clinically undetected CAP.
• Elevated PAP levels are frequently not indicative of metastatic CAP.
• Additional evidence is necessary to confirm metastatic CAP in patients with elevated PAP, even those with known CAP.