Currently in medicine much attention is paid not only to the treatment of diseases, but also to diagnosing their development in the early stages. This allows you to start therapy in a timely manner, which will significantly increase the chances of recovery. This is especially true of oncological diseases, in which delay in treatment can lead to serious consequences. In men, one of the methods for diagnosing prostate cancer is the study of PSA in a blood test. We will analyze the decoding and norm of values in the article.
Definition
PSA is a prostate-specific antigen. It is a protein produced by the prostate gland. It is a component of sperm. The main function of PSA is to liquefy sperm to allow free movement of sperm to the egg.
This protein does not getonly in the ejaculate. A very small amount is found in the blood. If a man develops an inflammatory process, the prostate gland begins to produce an increased amount of PSA, for which reason the analysis reveals a pathological change in the level of this protein in the blood.
The following forms of a specific protein are distinguished:
- General. It is prescribed most often, as it can indicate an early stage in the development of pathology.
- Free. Appointed less frequently, in most cases to clarify the diagnosis.
- Linked.
Total PSA levels can be affected by various external factors (such as a recent prostate massage) and benign diseases. In this regard, in some cases, to confirm an oncological diagnosis, a blood test is prescribed for the level of free PSA, the values of which will be reduced in case of malignant formation.
Norms
Venous blood is used to study the level of antigen in the blood, which is taken in the morning on an empty stomach.
When deciphering PSA in men, experts rely on those norms that take into account the age factor. This is due to the fact that in men after 50 years, the size of the prostate increases. This fact suggests increased PSA blood test rates.
Decryption will also depend on the presence of external factors that need to be told to the laboratory assistant before analysis. This may be a violation of preparatory recommendations, taking certain medications and more.
Most experts have come to the conclusion thatmen under the age of 50, the normal values in the decoding of the PSA analysis should not exceed 3 ng / ml. But some of the doctors are of the opinion that at this age the level of protein in the blood should be no higher than 2.5 ng / ml. An increase in values to 3 ng / ml should be a reason to take additional tests to exclude the development of an oncological process.
Currently, it is customary to use decoding by age in the analysis of PSA in men. The table of normal values is shown below.
| Age | Minimum values, ng/ml | Upper acceptable limits, ng/ml |
| Under 50 | 0, 7 | 2, 5 |
| 50–60 years | 1 | 3, 5 |
| 60–70 years | 1, 4 | 4, 5 |
| Over 70 | 2 | 6, 5 |
It should be noted that when deciphering the analysis of the total PSA, a zero value can also be the limit of the norm.
Diagnosing low levels of antigen in the blood of a man indicates a minimal risk of developing pathological conditions in the prostate gland. In the absence of pathological symptoms, there is no cause for concern in this case.
You should not independently decipher PSA in the blood, since only the attending physician after a comprehensive diagnosis can give an accurate result.
Indications for analysis
Initially PSA testin the blood of a man was prescribed only if a malignant formation of the prostate gland was suspected. But now experts have begun to use PSA decoding to diagnose benign formations in the prostate (for example, adenomas).
The most common test indications are:
- Suspicion of a tumor, both malignant and benign.
- Prevention of neoplasms of various nature in men after 40 years.
- Monitoring antigen levels in patients who have undergone radiation therapy. It is recommended to re-examine every 3 months.
- Watching for possible growth of prostate cancer. As a rule, in this case, the PSA level is viewed in dynamics. The rate of increase in the level of antigen in the blood depends on the rate of development of a malignant tumor.
- Assessing the effectiveness of prostate cancer treatment.
Also, the doctor may decide to prescribe the described analysis for the following patient complaints:
- On palpation, an enlargement of the prostate gland is felt.
- Frequent urge to urinate. This may cause pain and burning.
- Reduced desire and sexual activity.
- Pain in the groin, which may radiate to the lower back.
- Erectile dysfunction.
PSA analysis is recommended for people who have a history of a hereditary factor or harmful working conditions.
Preparing for analysis
To obtain accurate results when deciphering PSA in the blood, proper preparation is of great importance, since the antigen is very sensitive to the influence of external factors.
The following rules are recommended:
- Diet restriction. Do not eat or drink for 10 hours before the test.
- About a day to give up tea, coffee, juices. No smoking.
- Do not eat fatty, smoked, s alty foods 3 days before donating blood.
- Do not drink alcohol 4-5 days before the test.
- Abstain from intimacy for 5-7 days.
- After prostate massage, rectal ultrasound, and digital rectal examination, the test can be taken after a week.
- After a prostate biopsy, blood donation for PSA should be carried out no earlier than one month after the procedure.
- If the patient is taking any medications at the time of testing, the lab technician must be notified.
Additional examinations
To make a correct diagnosis, it is not enough to decipher the analysis of the total PSA. Often it is required to take into account the level of free PSA. This happens when there are doubts about the nature of the pathological process. In this case, total PSA and free PSA are measured. The interpretation of the obtained values reveals the ratio between these two indicators, which is calculated as follows: PSA free / PSA total x 100%. If receivedthe result is more than 25%, then we can talk about the benign nature of the pathological process. In the case when the ratio is less than 10%, a malignant process develops in the prostate gland. It is necessary to conduct additional examinations, which include the following laboratory and instrumental studies:
- Clinical blood test, in which special attention will be paid to the level of leukocytes and the erythrocyte sedimentation rate (ESR). An increase in these indicators indicates the presence of an inflammatory process in the body.
- Determination of PSA density. In this case, the ratio of the weight of the prostate gland (the characteristic can be detected by ultrasound examination) and the level of total PSA plays a role. An increase in density may indicate the development of a malignant process occurring in the patient's body.
- Ultrasound of the prostate, which can detect pathological changes in the organ.
- Biopsy. It is prescribed if PSA is more than 10 ng / ml and if even slight seals are detected in the prostate gland during palpation.
- TRUS (transrectal ultrasound diagnostics). Allows you to distinguish the benign nature of the pathological process from the malignant one.
Reason for increase
Aberrations in the interpretation of the PSA analysis associated with an increase in values do not always indicate a malignant formation. Consider some of the most common reasons for an increase in the level of a specific antigen in the blood:
- Benign growth of the prostate gland (adenoma).
- Problems with potency.
- Surgical intervention (for example, after removal of an adenoma).
- Infectious processes occurring in the prostate gland.
- Inflammatory processes.
- Injuries in the groin area.
- Mechanical intervention (e.g. massage, cystoscopy).
- Non-observance of sexual rest (before the analysis there was an ejaculation).
- Riding a bike.
- Prostate infarction.
- Enlarged prostate as an individual feature of the patient.
- Taking testosterone-boosting medications.
Table of possible values for pathologies
| Disease | Value, ng/ml |
| Inflammatory diseases of the prostate gland | Up to 10 |
| Prostate adenoma | to 10 |
| Oncology education | More than 10 |
| Malignant tumor with metastases | About 100 |
The presented table includes average values. The final diagnosis is made by the attending physician on the basis of the examination and the results of all prescribed tests.
It is worth noting that in patients who have undergone a prostatectomy (removal of the prostate gland), the PSA level in the blood should be 0.
Values from 4 to 10 ng / ml are borderline indicators at which it is impossible toconfidently talk about the benign or malignant nature of the pathological process. In this case, it is necessary to carry out a number of additional diagnostic measures.
Reasons for antigen growth
The reasons for the increase in antigen in different diseases are somewhat different. Let's take a closer look.
- In inflammatory processes in the prostate gland, an increase in PSA is due to impaired tissue patency.
- With adenoma, the volume of the gland increases and compression of its cells by adenomatous tissue is observed.
- Also, with adenoma, acute urinary retention is possible, which can lead to slightly elevated PSA levels in the blood.
- In prostate cancer, an increase in antigen occurs for two reasons: due to its production by malignant cells and when the barriers of the gland membrane are destroyed.
Free PSA
Deciphering the analysis of free PSA is somewhat different from the general one. With a malignant process in the prostate gland, its level will decrease relative to the norm. In a benign tumor, elevated levels of free PSA are diagnosed. The normal values in this case are indicators of 0.93 ng / ml.
The level of this form of antigen in the patient's blood in most cases is specified if it is necessary to confirm the diagnosis or to evaluate the result of the therapy of a malignant tumor. For example, if the analysis revealed an indicator of less than 15%, then we can talk about unfavorableforecast. If the values are in the range from 15 to 70%, the chances of recovery are quite high.
Indications for free PSA testing
- Seeing patients diagnosed with prostate cancer. Held in dynamics.
- Diagnosis of oncology, adenoma or prostatitis.
- Monitoring a patient diagnosed with adenoma. It is carried out for the purpose of early diagnosis of possible malignancy.
- Preventive measures for men over 45.
Prostate cancer treatment
If the increase in PSA in the blood of a man is caused by an oncological process in the gland, the doctor may use the following methods in treatment, depending on the stage of the cancer and the general condition of the patient:
- Radiation therapy. The most common method of treatment in which the affected organ is irradiated.
- Brachytherapy. Used in the absence of metastases. It is a type of radiotherapy. This is an effective type of treatment, which excludes the negative impact on he althy tissues.
- Prostatectomy. A radical method that is used in the absence of results of other treatment. It is an operation in which the prostate gland, adjacent lymph nodes and testes are completely removed.
After the therapy, it is necessary to systematically monitor the PSA level to confirm the effectiveness of the therapeutic measures taken and to exclude the possibility of relapse.
Conclusion
Conditionhe alth depends to a large extent on the individual. Oncological diseases can develop rapidly, so it is so important to diagnose them at an early stage, in which case the chances of a full recovery are quite high. Prostate cancer has a high mortality rate, so scheduled visits to the doctor should not be neglected, especially after reaching the age of 40 and having a hereditary factor in the anamnesis.
A blood test for PSA and its interpretation are of great diagnostic value. To obtain an accurate result, you must follow all the recommendations. With a timely visit to the doctor and passing all the necessary tests, it is possible to detect diseases of the prostate gland in the early stages, which will increase the chance of a successful recovery and prevent the development of a relapse. The attending physician deciphers the analysis of PSA in men.
