May 19, 2024

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What other reasons can cause PSA to rise except prostate cancer?

What other reasons can cause PSA to rise except prostate cancer?


What other reasons can cause PSA to rise except prostate cancer?

The prostate is a gland located under the bladder and surrounding the urethra. It is normal the size of a chestnut and is unique to men.



What is PSA?

PSA is a serine protease secreted by prostate acinar and ductal epithelial cells. It is directly secreted into the ductal system of the prostate. Normally, there is only a small amount of PSA in the blood circulation. If it is affected by tumors, hyperplasia and inflammation, normal glands The tube structure will be destroyed, causing the serum PSA concentration to rise to varying degrees.


The study found that the level of PSA is between 4-10ng/mL, and 16% of patients are diagnosed with prostate cancer by prostate biopsy; and when PSA is 10-20ng/mL, the probability of prostate cancer detected by biopsy is 38%; When the PSA exceeds 50ng/mL, the probability of a needle biopsy to find prostate cancer is as high as 80%.


Therefore, PSA has been a very valuable indicator for screening and early detection of prostate cancer, and it is widely used in clinical practice.


In addition to prostate cancer, what other reasons can cause PSA to rise?




Non-malignant prostate disease


Prostate inflammation, benign prostatic hyperplasia, acute urinary retention, prostate massage, etc. can increase PSA, but when the pathogenic factors are eliminated, it can become normal.


Serum PSA can be doubled after digital rectal examination. Therefore, patients undergoing digital rectal examination should be tested for PSA only one week after the examination.


PSA can be increased by 4 times after cystoscopy, and it can be increased by 53 to 57 times after prostate biopsy or transurethral resection of the prostate. Therefore, serum PSA can be tested at least 6 weeks after prostate biopsy.


Normal ejaculation, urinary tract infection and strenuous exercise can also increase PSA.


What other reasons can cause PSA to rise except prostate cancer?




Breast cancer

PSA is contained in normal, hyperplastic, or malignant breast tissue.


In benign breast lesions and breast cancer, the form of PSA contained in it is also different. In the serum of patients with benign breast disease, PSA is mainly presented as a complex.


Serum T-PSA and F-PSA in breast cancer patients will both increase, mainly F-PSA (accounting for more than 50% of T-PSA), which can reach more than 5 times that of patients with benign breast tumors.


The F-PSA level will decrease significantly after breast cancer surgery, and the T-PSA will only slightly decrease. Therefore, F-PSA and T-PSA in serum have guiding significance for the differential diagnosis of benign and malignant breast diseases.




Polycystic ovary syndrome (PCOS)


Studies have shown that serum T-PSA concentration and F-PSA concentration in patients with POCS will increase, and T-PSA/F-PSA will also increase significantly. The reason may be that PCOS is characterized by chronic anovulation and hyperandrogenemia, and androgens can stimulate PSA synthesis.





Female hirsutism


Female hirsutism refers to the excessive production of androgens in the female body or the increased sensitivity of the body to androgens, resulting in excessive growth of female hair, which is characterized by male distribution. More than 80% of hirsutism have increased androgen. Increased androgen levels will secondary to increase PSA synthesis.


Studies have found that the PSA of female hirsutism patients is significantly higher than that of healthy women, and that after 6 months of anti-androgen therapy, PSA will decrease. These studies have shown that PSA production is regulated by androgens.


As a marker of prostate cancer, PSA plays an important role in the diagnosis of prostate cancer, but prostate cancer does not necessarily mean that PSA is elevated. In addition, PSA is not unique to men. Under normal circumstances, a small amount of PSA is produced in women. Under certain diseases or medications, the synthesis of PSA in women will increase, or even increase significantly.


Article source: Clinical Laboratory Medicine, if there is any infringement or reprinting restriction on the subscription account, please contact us (or leave a message under the official account), we will contact you as soon as possible and delete it.





What other reasons can cause PSA to rise except prostate cancer?

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Important Note: The information provided is for informational purposes only and should not be considered as medical advice.