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[Advanced prostate cancer with normal serum prostate-specific antigen values]

T Komura1, K Yamagiwa, H Ogura

  • 1Division of Urology, Kinan General Hospital.

Hinyokika Kiyo. Acta Urologica Japonica
|July 10, 1998
PubMed
Summary

Prostate-specific antigen (PSA) can be normal in some advanced prostate cancer cases. This study found normal PSA levels in 7.6% of patients, indicating PSA is not always a reliable indicator.

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Area of Science:

  • Oncology
  • Biomarkers
  • Urology

Context:

  • Prostate-specific antigen (PSA) is a key biomarker for prostate cancer detection and monitoring.
  • Advanced prostate cancer (stages C and D) can present with normal PSA levels, complicating diagnosis and management.
  • Understanding variations in PSA expression is crucial for accurate patient assessment.

Purpose:

  • To investigate the prevalence and characteristics of advanced prostate cancer cases with normal pretreatment serum PSA levels.
  • To evaluate the reliability of PSA as a sole diagnostic and prognostic marker in these specific patient cohorts.
  • To analyze the correlation between histological findings and PSA expression in tissues from patients with normal serum PSA.

Summary:

  • A 5-year review of 131 patients with advanced prostate cancer identified 10 cases (7.6%) with normal pretreatment serum PSA levels.

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  • Histological analysis revealed variable cancer types in patients with normal PSA, with generally non-poor prognoses.
  • Immunostaining for PSA in resected tissues showed positive results in 5 cases, negative in 3, and equivocal in 2, highlighting discrepancies.

    • Impact:

    • Challenges the universal utility of PSA as a definitive marker for advanced prostate cancer.
    • Suggests the need for complementary diagnostic methods when PSA levels are unexpectedly normal.
    • Informs clinical practice regarding the interpretation of PSA results in the context of advanced disease and potential tissue expression variability.