Dog blood test results deciphered. PSA test: why is this blood test taken and what are its normative values? What does the PSA level in the blood show?

PSA (prostate specific antigen) is a biological protein substance in the blood serum of men. Thanks to its quantitative content, it is possible to assert with a sufficient degree of confidence about signs of a violation of the organic functionality of the prostate, more often of an oncological nature.

Prostate specific antigen (PSA) - what is it?

Prostate specific antigen (synonyms: prostate-specific antigen, gamma seminoprotein, kallikrein-3) is a protein substance belonging to the group of glycoproteins, secreted by epithelial cells of the prostate gland.

A large concentration of PSA is part of the secretion of the prostate gland, the main physiological role of which is to prepare the urethra of the penis immediately before ejaculation (it is irrigated), to liquefy the ejaculate and dissolve cervical mucus, which ensures favorable movement of sperm into the uterine cavity.

A certain amount of PSA is always present in the blood serum. With some diseases or dysfunctions of the prostate gland, the PSA level, as a rule, increases, which makes it possible to judge the presence of pathologies and their quality in the prostate parenchyma.

The ratio of the amount of prostate-specific antigen in serum for the purpose of prostate screening was first studied in 1980. Since then, this indicator has been used with varying degrees of success in the medical practice of many countries for the diagnosis of malignant pathologies of the prostate, as well as prostatitis and benign hyperplasia of this gland.

It should be noted that, starting in 2012, the United States began to gradually abandon the unambiguous quantitative indicators of prostate antigen in relation to prostate cancer typing. They explained this by saying that an excess of PSA in the blood serum does not always indicate the presence of cancer, and erroneous conclusions can lead to the phenomenon of overdiagnosis and incorrect, irrelevant treatment. In addition, specific therapy for prostate cancer is often associated with risks of complications such as erectile dysfunction and urinary incontinence. According to foreign colleagues, the possible benefits of treatment do not outweigh its expected harm.

In any case, an increase in the level of prostate-specific antigen in the blood serum indicates the presence of pathology in the gland in 95% of cases. But a much more accurate diagnosis of the type of pathology and its characteristics can only be determined by additional research. Of the total number of patients with elevated PSA levels, cancer was reliably diagnosed in only 30%.

Indications for prescribing a PSA blood test

As already mentioned, an increased level of PSA in the blood serum of men allows us to suspect oncological pathologies of the prostate gland, as well as a number of other diseases that require therapeutic intervention.

The physiologically healthy state of the prostate determines certain quantitative characteristics of the prostate antigen, which directly depends on the age of the person. After all PSA levels increase over the years , which is explained by the aging of the epithelial productive layer of the gland.

• Until the age of 49, the normal amount of PSA in the blood serum should not exceed 2.5 ng per 1 ml of serum.
• From 50 to 59 years - no more than 3.5 ng/ml.
• From 60 to 69 years - no more than 4.5 ng/ml.
• Over the age of 70 years - no more than 6.5 ng/ml.

Unlike theoretical reference data, Practical medicine sets slightly different limits for the optimal PSA content. Thus, the maximum threshold at the age of up to 50 years is considered to be up to 4 ng/ml.

It should be noted that the threshold value in 10 ng/ml causes the presence of the so-called "gray zone" when the likelihood of cancer or other pathology occurring is quite high. However, performing a biopsy in order to exclude oncology as reliably as possible remains questionable. After all, excessive intervention in the structure of the prostate gland is strictly not recommended, due to its weak resistance to external influences.

Pathological conditions of the prostate gland can occur at any age. However, as a rule, initially elevated levels of prostate antigen are determined after the age of 40, when an annual examination of the prostate is recommended. At a younger age, visiting a doctor is due to the manifestation of specific symptoms characteristic of

• Frequent urination, especially at night.
• A constant feeling of an insufficiently emptied bladder and severe pain.
• Urine excretion occurs in portions with long delays between them.

The presence of this kind of symptomatology, as well as an increased PSA level during the initial examination, determines the need for additional tests and manipulations.

• Digital rectal examination of the prostate gland to examine the consistency of the organ.
• When seals are detected a number of studies are prescribed, including additional PSA test.
• In turn, the amount of prostate antigen more than 10 ng/ml may contribute to the decision to undergo prostate biopsy.

In addition, there are a number of indications for conducting studies on the amount of prostate antigen:

• monitoring the condition of the prostate gland and the quality of treatment during oncological or other types of therapy;
• if during the initial digital rectal examination or ultrasound, changes in the anatomical structures of the prostate were found;
• after a radical antitumor treatment regimen, PSA analysis is performed at least once a quarter;
• Possessing a fairly branched network of blood vessels, against the background of a high productive load, the structure of the prostate gland is often subject to trophic insufficiency due to organic vascular disorders, i.e. e. ischemia or heart attacks. This situation also requires additional tests to determine the amount of PSA.

Causes of increased PSA in blood serum

The increase in the amount of prostate antigen, regardless of the type of prostate pathology, is always based on organic damage to the productive epithelium of the gland, which occurs in certain pathological conditions.

Benign prostatic hyperplasia (BPH)
A benign disease characterized by:

• the formation of multiple nodular formations from epithelial cells and stroma of the gland;
• absence of metastases beyond its borders.

BPH is a fairly common pathology. It affects more than half of the entire male population over the age of 40 years. The etiology of the disease has been little studied, however, there are a number of scientific opinions about the dependence of BPH on the decrease in the amount of male hormones and the age of the person when the period of the so-called male menopause begins.

Until some time, the disease was called “prostate”, however, due to the benign nature of the pathological processes and the high frequency of occurrence, they decided to classify the pathology as a different nosological group.

The pathogenesis of BPH is characterized by a physical increase in the volume of the prostate and degeneration of the epithelial productive layer, as a result of which it begins to produce significant amounts of PSA.

Prostate carcinoma or prostate cancer

Oncological malignant disease, characterized by an acute course in the final stages and high mortality among men (about 10% of the total male population). In contrast to the benign course, atypical substances are formed only from the epithelial cells of the gland, thereby causing excessive formation of prostate antigen.

Another feature of prostate cancer is the growth of an individual tumor outward, in contrast to an adenoma, which contributes to a uniform increase in the entire gland and, as a result, compression of the urinary canal. This picture contributes to a long-term latent malignant course, because the patient does not experience symptoms when urinating.

Infectious inflammatory processes in the prostate gland

They help increase the permeability of the walls of small blood vessels that supply the parenchyma of the organ, which also contributes to the hyperproduction of PSA due to destructive changes in epithelial cells.

The course of acute prostatitis can be caused by a wide range of different microorganisms.

• Escherichia coli.
• Klebsiella.
• Proteus.
• Pseudomonas aeruginosa.
• Others are opportunistic in nature, but penetrate into the prostate tissue, turning into a pathogenic state and stimulating the development of prostatitis.

Preparing for analysis and taking material for research

The level of PSA in the blood serum steadily increases as a result of any kind of impact on the prostate gland due to the development of pathological conditions or therapeutic effects.

Reliable accuracy of the analysis can be guaranteed only after a certain period of time has passed after physical exposure or complete cure of infectious diseases:

• complete abstinence from ejaculation is recommended for at least in two days before the study;
• digital rectal examination should be performed no earlier than in three days before analysis;
• the transrectal ultrasound (TRUS) technique does not guarantee the accuracy of the PSA test result within a week;
• After a biopsy of prostate tissue, analysis for the quantitative content of prostate antigen can only be carried out in 1.5-2 months after collecting histological material;
• if cystoscopic examination of the bladder or its catheterization was carried out, the analysis is carried out no less than in two weeks;
• the longest waiting period for transurethral resection of the prostate - after these manipulations, reliable results of analysis for the quantitative content of PSA are possible only after six months.

Carrying out the analysis for the patient is not particularly difficult and does not require special preparation.

• A fasting diet is required on the day of delivery.
• To take a sample, a classic blood sample is taken from a vein in a volume of no more than 10 ml.
• Direct analysis in the laboratory takes no more than one day.

Free, bound and total PSA

Biologically, prostate antigen can be present in the blood in two states, which is determined directly during laboratory testing - free and bound to blood proteins.

In a healthy prostate gland, both forms of PSA are present in the blood serum, in the ratio of bound and free forms, respectively, 9:1.

The pathological effect of malignant oncological products on the epithelium of the prostate gland contributes to an increase in the number bound PSA, thereby changing the normological ratio indicated above. This phenomenon is not typical for pathologies of non-cancerous prostate origin.

To simplify the calculations of the above ratio when diagnosing carcinomas, we derive total PSA, which is obtained by summing the free and bound prostate antigen, then dividing the quantitative value by it free PSA and multiplied by 100% to obtain an exponential ratio.

Prostate cancer (PCa) occupies one of the leading places in the structure of mortality from cancer in men. Prostate cancer has nonspecific symptoms initial stages illnesses such as pain, difficulty urinating, blood in the urine. The disease may for a long time proceed completely asymptomatically. Often patients seek help only with complaints of pain in the bones, which indicates an advanced stage of the disease, metastasis to the bone tissue.

Deciphering the study results by age makes it possible to differentiate the variant of the age norm from pathology, and to identify high-risk groups for a more detailed examination.

Determination of prostate-specific antigen helps to identify early forms of cancer in patients who do not present specific complaints, as well as to evaluate the results of treatment of benign and malignant prostate diseases.

Screening studies, including an examination by a urologist and a PSA test in men, help to identify the disease at an early stage, when treatment is most effective.

What is a PSA test?

Prostate specific antigen (PSA) is normally present in the blood of men. Its structure is a glycoprotein that is secreted by prostate duct cells. It is needed to liquefy the ejaculate - this is one of the important factors, contributing to the implementation of male reproductive function.

Prostate-specific antigen is mainly determined as a tumor marker for prostate carcinoma. This indicator is a guideline when choosing the volume of surgery. After the therapy, its assessment indicates the effectiveness of the treatment. Also, its meaning is important in the diagnosis and treatment of prostate adenoma.

• The main amount of PSA is contained in the ejaculate. The amount of prostate-specific antigen in the blood is normally very small, which is due to the histohematological barrier.
• In various situations, serum PSA rises, indicating barrier disruption, most often due to tissue growth, inflammation or mechanical action.

What is total and free PSA

The antigen is present in the blood in the following form:

• PSA free;
• Fractions associated with antiproteases:
  • 1) alpha 1-antichymotrypsin,
  • 2) alpha 2-macroglobulin. The last fraction is not determined.

The following two quantities have clinical significance:

• PSA total (PSA total), including PSA - free, as well as PSA - associated with alpha1-antichymotrypsin);
• Free PSA (f-PSA)

Free PSA/total PSA ratio

Used to identify indications for morphological examination (biopsy) in a certain group of patients. A biopsy will be ordered if the patient's free to total PSA ratio is below 15%.

It should be clarified that if the prostate volume is more than 40-60 cm3, this ratio is not very informative.

Interpretation of PSA results in a blood test depending on age

It is believed that on average, PSA should not be more than 4 nanograms per milliliter. However, this is not an entirely correct statement. The decoding of the analysis takes into account the age of the man, because PSA in the blood will be higher, the larger the volume of the prostate, which increases with age.

An increase in PSA between the ages of 50 and 70 years occurs in 15% of cases, and does not always indicate malignant organ damage.

PSA analysis, normal by age

Table 1.

Up to 40 years of age, the upper limit of the indicator is 2.5 ng/ml.

The normal free PSA value ranges from 0.04 to 0.5 ng/ml. The above value is usually used to calculate the ratio of PSA fractions.

Primary screening

Table 2.

The above values ​​are approximate and average, relate only to the initial screening, and depend on the patient’s age and many other factors. Only the attending physician can interpret the results obtained during the study.

An increase in total PSA ranging from 4 to 10 ng/ml is what urologists call a “gray zone.” With this value, it is impossible to reliably talk about a malignant or benign process.

On average, at this PSA value, 30% of men are diagnosed with prostate cancer. For verification, a morphological examination and fine-needle biopsy of prostate tissue are prescribed.

It must be taken into account that even if PSA is less than 4 ng/ml, there is a risk of detecting malignant foci.

PSA in a man’s blood increases with various diseases:

• during the inflammatory process in organs genitourinary system;
• acute prostatitis;
• chronic inflammation of the prostate, in exacerbation;
• prostate adenoma;
• impaired blood supply to prostate tissue;
• prostate infarction;
• when a malignant focus appears in the prostate tissue

An increase in PSA in the blood does not always indicate oncology.

Reasons for PSA growth in diseases

• During inflammatory processes in the gland tissue, the reason for the increase in PSA is a violation of tissue permeability.
• In prostate cancer, prostate-specific antigen enters the blood for two reasons: it is produced by cancer cells, and the membrane barriers of the gland are destroyed.
• In case of adenoma - due to an increase in the volume of the gland and compression of prostate cells by adenomatous tissue.
• Impaired urinary passage in the form of acute retention in adenoma can lead to an increase in PSA.

Factors that could potentially cause growth

• performing prostate massage;
• cycling, motorcycle riding, horse riding;
• ejaculation on the eve of blood collection;
• performing cystoscopy;
• catheterization of the bladder, especially catheterization with a rigid catheter (currently used quite rarely);
• taking medications to treat BPH.

“Diagnostic triad” of prostate cancer screening

1. Serum PSA test.
2. Rectal examination.

Simple and effective method, complementary to the PSA determination. Most often, prostate formations have peripheral growth, which makes it possible to palpate nodes measuring less than half a centimeter in diameter. With central growth of the tumor, the information content of palpation decreases.

The sensitivity of the diagnostic combination including PSA test + rectal examination is 93%

III. Transrectal echography of the prostate gland (TRUS) is much more informative in comparison with abdominal ultrasound, allowing one to differentiate benign hyperplasia from malignant formation. During the study, the volume of the prostate is measured and the PSA density index is calculated: the PSA level divided by the volume of the prostate. The risk of being diagnosed with prostate cancer increases when PSA density exceeds 0.15.

These methods complement each other and together provide a more accurate diagnostic picture.

Additional diagnostic methods

If there are clinical and laboratory indications, morphological verification of the suspected disease is performed. The most effective method was transrectal multifocal puncture biopsy of the prostate under ultrasound control. This is a minimally invasive procedure that can be performed on an outpatient basis without hospitalization.

In what cases will the doctor prescribe a prostate biopsy?

1. PSA > 10 ng/ml;
2. PSA 4-10 ng/ml, free/total PSA< 15%;
3. PSA within the age norm + presence of signs of malignancy (determined both by palpation and ultrasound diagnostics);
4. PSA increase > 20%, or 0.75 ng/ml per year.
5. If the doctor suspects a patient has cancer, even in the absence of tumor cells in the prostate punctate, dynamic observation is indicated.

PCa screening

Screening is an examination of individuals who do not have symptoms of the disease in order to diagnose latent diseases or risk factors.

In what case is it rational to conduct a screening study:

1. Patients from fifty to seventy years of age without severe somatic pathology, who, when diagnosed with cancer, can undergo radical treatment;
2. Patients complaining of problems with urination;
3. Patients with diseases of the genitourinary system, whose age is over 50, with a previously unknown tumor marker, if surgical treatment is planned, or drug therapy for BPH or chronic prostatitis;
4. Patients over 40 with an unfavorable hereditary history, that is, having close relatives with verified prostate cancer.

There are discussions about lowering the age threshold for including men from forty years of age in primary screening.

Indications for re-testing in a group with an initially low PSA:

• if PSA is more than 1 ng/ml, get tested once every three years;
• with PSA 1-1.99 ng/ml - once every two years;
• if the PSA value is more than 2 ng/ml, it is recommended to be tested once annually.

Rate of increase

A considerable amount malignant neoplasms prostate (according to various sources from 20% to 40%) are found with normal PSA, therefore its value should be determined in dynamics.

An increase of 0.75 ng/ml per year positively correlates with the incidence of cancer detection.

Rules for donating blood for PSA

• cancel intense physical activity 48 hours before the test;
• refrain from ejaculation 48 hours before blood collection;
• 7 days must pass after the rectal examination;
• after prostate massage – 7 days;
• trips by bicycle, motorcycle - after 7 days;
• transrectal ultrasound can increase PSA levels, and therefore it is recommended to delay PSA determination for 7 days;
• more than 6 weeks must pass after a fine-needle multifocal biopsy of the prostate;
• if the patient has inflammatory diseases of the urinary tract, the test should be postponed until recovery;
• after surgery - transurethral resection of the prostate (TUR), the study should be done only after 6 months.

An increase in prostate specific antigen does not always indicate cancer. A timely visit to a urologist will allow you to reliably establish the cause of the increase and prescribe appropriate treatment in a timely manner.

It can take a decade from the moment a microscopic tumor focus appears in the prostate gland to the terminal stage of the disease. Medical examinations of the prostate gland, including donating blood for tumor markers and rectal examination of the prostate gland, will help you not to miss the early forms of the disease, when therapy is most effective.

How to donate blood for PSA in Moscow?

A PSA blood test is prescribed to men over the age of 50 (sometimes earlier) for the purpose of early diagnosis of prostate cancer.

This test can be taken by every Muscovite who has a compulsory medical insurance policy at any level 1 medical organization (polyclinic) of the Moscow Health Department.

1. Make an appointment with a general practitioner or urologist.
2. Get a referral for a PSA blood test
3. Come to the clinic at the appointed time. Take your referral and compulsory medical insurance policy with you.
4. You can find out the results of the analysis from your general practitioner or urologist 5-7 days after the test.

What does the PSA level in the blood show?

A PSA test is not enough to make a final diagnosis: this screening test allows us to establish an increased risk of prostate cancer, and an accurate diagnosis can only be made after a prostate biopsy.

How to take the test correctly?

Two weeks before the test The following procedures should not be carried out:

• Prostate massage, digital rectal examination and any other mechanical effects on the prostate;
• Transrectal ultrasound;
• Cytoscopy or catheterization of the bladder;

4-5 days before the study you need to refrain from sexual activity and heavy physical exertion.

A few hours before the test It is best not to expose the body to emotional stress. A PSA blood test is taken from a vein on an empty stomach.

What is a normal PSA level?

This depends primarily on your age.

Approximate normal PSA values ​​depending on age are presented in the table

What to do if your PSA level is higher than normal?

First of all, do not panic: the main thing is that you have already been warned. Further clarification of the diagnosis will also take place under the compulsory medical insurance program in one of the medical organizations of the Moscow Health Department.

http://navigator.mosgorzdrav.ru/columns/urologiya/komu_i_zachem_nuzhno_sdavat_krov_na_psa/

Prostate tests are the key to men's health

Disturbances in the functioning of the prostate can lead to the most tragic consequences. Contrary to popular belief that diseases of this kind mainly affect the elderly, today it is young men who suffer from various ailments in this area. Any disease of the prostate gland significantly worsens the general well-being of the patient, negatively affects the quality of intimate life, and sometimes the ability to conceive.

Medicine identifies several main prostate diseases:

• prostatitis- an infectious inflammatory process in the gland, characterized by an increase in the size and swelling of the organ;
• vesiculitis- complication of prostatitis, accompanied by inflammation of the seminal vesicles;
• fibrosis- urinary dysfunction;
• stones in the prostate resulting from kidney pathology;
• prostate tuberculosis;
• adenoma- benign neoplasm in the prostate;
• sarcoma (prostate cancer)- a type of malignant tumor that can occur in men at a young age.

It is almost impossible to diagnose a specific disease only by external symptoms, since most prostate diseases cause difficulty urinating, incontinence, pain in the lower abdomen and groin area, the appearance of blood in semen - that is, symptoms common to all pathologies. For an accurate diagnosis, a whole range of tests is required.

For preventive purposes, prostate examinations are considered mandatory for all men over 40 years of age, since the so-called male menopause begins at this age. The hormonal balance in the body is disrupted, which can cause diseases. In addition, preventive examination of the prostate is indicated for expectant fathers, athletes, especially cyclists and wrestlers, office workers whose sedentary lifestyle leads to stagnation of blood in the prostate gland.

Important!
In middle or old age, almost 50% of men suffer from prostate diseases.

Where can I submit material for research?

If alarming symptoms occur, you should consult a urologist. It is this doctor who specializes in the treatment of prostate diseases and prescribes the necessary set of tests. You can submit biomaterial for analysis in a public or private clinic or in a specialized laboratory. If everything is clear with the first two types of institutions, then the latter appeared not so long ago. Today in Russia there are several large laboratories with branches in different cities. The main advantage of an independent laboratory is the availability of its own equipment and qualified personnel. This guarantees high accuracy, minimal price and speed of analysis: on average - one day, and urgent analyzes can be ready within one to two hours. Payment is made only for the necessary research. Some laboratories don't even require you to come in to get the results - they can be delivered by courier or sent by email.

But in any case, wherever the patient decides to take tests, only a doctor should interpret their results and make prescriptions.

Analysis of prostate secretions

Analysis of secretion (juice) is the main study that mandatory prescribed by a urologist if prostate disease is suspected. This is an easy-to-use but very informative method. By changing the characteristics of the secretion, the doctor can judge the presence of organ pathology and the degree of its development.

Indications for the study are pain in the groin and perineum, pain when urinating, frequent urination, especially at night, and bright yellow discharge from the urethra. Prostate juice analysis is also carried out to diagnose male infertility. But the analysis is contraindicated for prostate tuberculosis, the presence of rectal fissures, hemorrhoids in the acute stage and acute inflammatory diseases accompanied by high fever.

The norm for analyzing prostate secretions is the following indicators:

• secretion volume is 0.5–2 ml, a decrease or increase in the amount is a sign of an inflammatory process;
• color - white transparent or yellowish;
• lecithin grains - 10 million per 1 ml of secretion, a decrease indicates the presence of a disease;
• density - 1.022;
• acidity (pH) - neutral, equal to 7.0, with deviations in both directions no more than 0.3;
• leukocytes - no more than 10 per field of view, a larger number indicates inflammation;
• macrophages are not detected, the presence indicates inflammation;
• red blood cells are absent or rare, the presence indicates a disease;
• bacteria and fungi are absent, the presence indicates prostatitis;
• Escherichia coli, gonococcus, and trichomonas are absent.

To prepare for the test, the patient is recommended to reduce physical activity 5–7 days before the test, abstain from sexual intercourse, drinking alcohol, and visiting a bathhouse or sauna. Immediately on the day of the analysis, it is necessary to give an enema to cleanse the intestines.

How is prostate juice analyzed? The manipulation itself is as follows: the man lies on his side or takes a knee-elbow position. The doctor performs a prostate massage using a special technique and collects the resulting fluid in a special container. If the manipulation is ineffective, then the first portion of urine is collected, which contains a small amount of secretion. The collected secretion is sent to the laboratory for testing.

The results of prostate juice analysis are usually ready two days after the procedure, the average price is 450 rubles.

Urethral smear analysis

A urethral flora smear in men can reveal several indicators at once, indicating the presence of diseases in the body:

• prostatitis;
• urethritis and ureaplasmosis;
• chlamydia and gonorrhea.

Signs indicating the presence of the disease and the need for testing are severe itching and burning in the urethra, pain and discomfort during sexual intercourse or urination, and the appearance of uncharacteristic discharge. The smear can be taken by a urologist or in a special laboratory. The dried material is examined under a microscope.

Normally, a smear analysis looks like this:

• the presence of squamous epithelial cells, their absence indicates atrophy of epithelial cells;
• leukocytes - up to 15 units, during the inflammatory process their number increases sharply;
• rods in a smear are normal microflora, the presence of other microorganisms is not normal;
• yeast fungi, trichomonas, gonococci should not be detected in the smear.

• 7–10 days before the procedure, stop taking all medications;
• 2 days before the analysis, abstain from sexual intercourse;
• carry out hygiene procedures the night before going to bed, but not before visiting the doctor;
• 2 hours before the test do not urinate.

The smear procedure itself may be a little painful for the patient, since it is carried out by inserting a special sterile brush into the sensitive urethra. For some men, pain persists for several hours after completion of the procedure. The manipulation takes less than 5 minutes, and the results are given to the patient after 2 days. The cost of analysis is on average 440 rubles.

Analysis of urine

One of the most common types of tests, prescribed for the diagnosis of almost any type of disease and being very informative. If you suspect a prostate disease, your doctor may prescribe three types of urine tests:

• general;
• cytological;
• bacteriological.

General analysis urine allows you to obtain data on the state of the urinary system and includes the study of chemical and physical properties urine, microscopic examination of sediment.

Urinalysis is normal with the following indicators:

• color - from light yellow to yellow;
• density - 1.008–1030 g/l;
• transparency - transparent or slightly cloudy;
• pH - within 5–7;
• protein - not determined;
• leukocytes - up to 3 units;
• red blood cells - no more than 3 in the field of view;
• urobilin - less than 17 mol/l.

All other indicators must be equal to zero.

On the eve of the study, it is necessary to exclude from the diet vegetables that change the color of urine, some medications(aspirin, diuretics). It is also necessary to exclude alcohol consumption and physical overexertion. On the morning of the test, the external genitalia are toileted and urine in a volume of 10 ml is collected in a pre-prepared sterile container, which must be delivered to the laboratory as quickly as possible.

The analysis is completed within 1 working day, the cost is 350 rubles.

Cytological analysis is carried out in parallel with the general one, and the same portion of urine is used for its implementation. It shows changes in prostate tissue and is necessary to exclude cancer. The execution time is up to two working days, the average price is 840 rubles.

Bacteriological analysis identifies infectious agents, especially when the doctor suspects a bacterial form of prostatitis. Bacterioscopy is performed by collecting three portions of morning urine in different containers and inoculating urine on a nutrient medium. The presence of microbes and their type are determined within a period of several days to two weeks. The cost of the study is on average 900 rubles.

Blood analysis

Prostate diseases in the early stages are quite difficult to diagnose, so the doctor must prescribe a blood test to the patient. If prostatitis or other diseases are suspected, several types of studies are usually prescribed:

• general blood analysis;
• blood chemistry;
• prostate specific antigen (PSA) test.

For general analysis Blood is donated in the morning on an empty stomach. It is advisable not to consume fatty foods or alcohol the day before, and not to smoke for an hour before taking the test.

A normal blood test contains the following indicators:

• leukocytes - no more than 9x109 in 1 liter;
• ESR - 5 mm/h;
• band leukocytes - no more than 4 in the field of view;
• hemoglobin - 130 g/l.

The cost of a general blood test is from 300 to 1020 rubles, depending on the scope of the study. It is carried out in one working day, urgent analysis is completed in two hours.

Blood biochemistry(minimal) includes the following tests:

• protein fractions;
• creatinine;
• urea;
• glucose;
• total cholesterol;
• total bilirubin;
• direct bilirubin;
• ALT (alanine aminotransferase);
• AST (aspartate aminotransferase);
• gamma-glutamyl transpeptidase (GGT);
• alkaline phosphatase (ALP);
• total protein (in blood);
• potassium, sodium, chlorine.

The cost of a biochemical blood test is on average 3,600 rubles, the completion time is 1 day.

PSA blood test necessary in cases where prostate cancer is suspected. Normal PSA data differs in men of different ages. For example, up to 40 years of age, the normal PSA content is considered to be less than 2.5 ng/mg, from 40 to 50 - more than 2.5 ng/mg, from 50 to 60 - more than 3.5 ng/mg, 60–70 years - more 4.5 ng/mg.

On a note
An elevated PSA level is not necessarily a sign of cancer in the body. The reason may be the advanced age of the patient. In men over 70 years of age, its level is often more than 6.5 ng/mg.

The average price of a PSA blood test is 600 rubles, taking blood from a vein is 200 rubles. Completion time is one day.

Sperm analysis

A spermogram is also an informative study that allows you to identify the inflammatory process of the prostate gland. Normal sperm should remain highly viscous for several hours after ejaculation. The volume of ejaculate should be at least 1.5 ml; with chronic prostatitis it decreases to 1 ml, and with bacterial or stagnant prostatitis it becomes even less. The pH of sperm in a healthy man is 7.2-7.8. Changes in the indicator in any direction also indicate the presence of the disease.

Inflammation of the prostate also affects the change in the color of sperm from white or yellowish to brown or even red. In addition, the liquefaction parameters of the ejaculate change. With prostatitis, the liquefaction time exceeds 1 hour. The presence of pathogenic microflora, epithelial cells and mucus in sperm is unacceptable.

Obtaining biomaterial is usually carried out in the laboratory through masturbation. Some clinics provide an option where the patient collects sperm at home and brings it himself for analysis. But in this case, it is necessary to deliver the biomaterial to the laboratory within an hour after receiving it, so as not to reduce the reliability of the results.

The execution time is 1 working day, the average cost of analysis is 1500 rubles.

Obvious symptoms of prostate diseases may not manifest themselves for a long time, so patients often consult a doctor only when time has already passed. When the first, most minor signs of prostate dysfunction appear, you must contact a specialist and undergo all the necessary tests for an accurate diagnosis and receipt of timely and effective medical care.

https://www.kp.ru/guide/issledovanie-prostaty.html

What is this analysis used for?

• For screening of prostate tumors.

• For clinical symptoms of prostate pathology in men of older age groups;
• during preventive examination of men from risk groups.

Synonyms Russian

Prostate-specific antigen is common and free; Total PSA + free PSA.

English synonyms

Prostate cancer screening.

Research method

Chemiluminescent immunoassay.

Units

ng/ml (nanograms per milliliter), % (percent).

What biomaterial can be used for research?

Venous blood.

How to properly prepare for research?

• Eliminate fatty foods from your diet 24 hours before the test.
• Avoid physical and emotional stress for 30 minutes before the test.
• Do not smoke for 30 minutes before the test.
• The study should be carried out no earlier than 10 days after prostate massage (receiving prostate secretions, massage of seminal vesicles).

General information about the study

Composition of the complex: 2 studies

• Prostate-specific antigen (PSA) total
• Prostate-specific antigen (PSA) free

Prostate cancer is one of the most common neoplasms in men. In the world, it ranks 3-4th in prevalence among malignant neoplasms, and in some countries of Europe and America it ranks first among the causes of death from cancer among men in older age groups.

It usually develops very slowly over many years. Symptoms of the disease appear only with a significant increase in tumor mass, compression of the urethra and impaired urine outflow. A prostate tumor can be suspected if the patient complains of frequent, nocturnal, painful urination, a weak stream of urine, an admixture of pus or blood in the urine, discomfort in the lower abdomen, in the pelvis, and impaired sexual function.

However, these symptoms are nonspecific and can occur with benign prostatic hyperplasia, urinary tract infections, inflammation of the prostate gland, and sexually transmitted infections. Early diagnosis of a neoplasm allows timely treatment and prevention of life-threatening consequences. Tumor growth without timely diagnosis and treatment can lead to metastases in bone tissue, kidneys, and lungs. More than 70% of newly diagnosed prostate cancer cases are diagnosed in men over 65 years of age. In this regard, in men of older age groups, the appearance of symptoms of genitourinary dysfunction requires the mandatory exclusion of prostate cancer.

Some countries have developed recommendations for screening patients without clinical symptoms of prostate pathology. The American Urological Association identifies several levels of risk for developing prostate cancer in asymptomatic patients: moderate risk (healthy men with no family history), increased risk (if a close relative (brother or father) has prostate cancer under the age of 65 years), high risk (if there is a neoplasm in more than one relative at any age). In the moderate-risk group, prostate-specific antigen (PSA) levels and digital prostate examination are recommended annually after age 50; at increased risk – from 45 years of age; at high risk – from 40 years of age.

Prostate-specific antigen (PSA) is a glycoprotein that is produced in the prostate gland. It is mostly secreted in the seminal fluid and only a small amount enters the blood. PSA in the blood consists of two fractions - bound to alpha-1-chemotrypsin and free (not bound to protein). With prostate tumors and some other prostate diseases, the content of total and bound PSA in the blood increases. The sensitivity and specificity of total PSA for the diagnosis of prostate cancer is only 20-40%, but increases when free PSA is measured simultaneously. This laboratory test is not diagnostic, but screening. Only in a third of cases, with an increase in total PSA, the diagnosis of prostate cancer is confirmed. The “gold standard” for diagnosing prostate cancer is a prostate biopsy with histological examination of the material. Simultaneous determination of total and free PSA makes it possible to differentiate prostate cancer from other non-cancerous prostate diseases. Determination of the level of total and free PSA together with a digital examination of the prostate determines the feasibility of a prostate biopsy to clarify the diagnosis. The goal of this screening study is to reduce the number of unnecessary prostate biopsies.

The advisability of prescribing this test in patients without any symptoms depends on the presence of risk factors and is decided with the participation of the attending physician on an individual basis.

What is the research used for?

• Screening for prostate tumors;
• decision on the advisability of performing a prostate biopsy;
• assessing the effectiveness of prostate cancer treatment;
• diagnosis of recurrent prostate cancer.

When is the study scheduled?

• If the patient complains of difficult, painful and frequent urination;
• with an increase in the size, consistency and structure of the prostate gland according to digital examination or ultrasound;
• during a routine examination of men over 50 years of age (in the absence of risk factors), at the age of 45 years (with an increased risk) or at 40 years of age and earlier (with a high risk of developing prostate cancer);
• annually if PSA rises above 2.5 ng/ml or if there is a high risk of developing prostate cancer;
• during and after treatment for prostate cancer.

What do the results mean?

Reference values

Total prostate-specific antigen (PSA total): 0 - 4 ng/ml.

Free PSA / total PSA ratio: 25 - 100%.

Reasons for increased total PSA:

• Benign prostatic hypertrophy
• Prostate cancer (about 80% of cases are accompanied by an increase in total PSA)
• Prostatitis, prostate injury
• Impotence
• Recent sexual activity
• Urinary tract infection
• Urinary retention
• Urological procedures

With a total PSA level of 4 to 10 ng/ml and a negative DRE (digital rectal examination) result:

free PSA/total PSA ratio< 10 % – высокий риск РПЖ;

free PSA/total PSA ratio > 25% – low risk of prostate cancer.

(According to Guidelines on Prostate Cancer. European Association of Urology 2015).

What can influence the result?

With age, the level of total PSA in the blood gradually increases.

A false increase in total PSA is possible with:

• digital examination of the prostate, transrectal ultrasound of the prostate gland before taking blood for analysis;
• prostate biopsy a few weeks before the test;
• after research using radioisotope preparations;
• recent cystoscopy, bladder catheterization, or urinary tract infection;
• ejaculation 24-48 hours before the test;
• sexually transmitted infections;
• after cycling.

Medicines that affect the level of total PSA: allopurinol, finasteride, cyclophosphamide, methotrexate, androgen antagonists.

Important Notes

• The need to prescribe this test and the frequency of its implementation should be determined by the attending urologist.
• An increase in PSA in men is not an absolute sign of prostate cancer. The diagnosis can be confirmed or excluded only by the results of a prostate biopsy. Only 30% of patients with elevated PSA levels are diagnosed with prostate cancer.
• When found higher level total PSA, some doctors recommend repeating the test 6 weeks - 3 months after the first test and then deciding whether to perform a biopsy of the gland.
• PSA level determination not recommended carry out 24-48 hours after cystoscopy, ejaculation; within 7 days after a digital examination of the prostate, ultrasound of the prostate gland and other urological procedures; earlier than 6 weeks after prostate biopsy; earlier than 8 weeks after treatment of prostatitis.

Various laboratory tests are used to identify problems with the prostate gland. One of the dangerous and difficult to define diseases is.

A general PSA test, which is performed on a sample from a blood sample, can confirm or refute this disease.

The article will tell you what this method is, how often and how it is carried out, and what its results say.

Many patients are interested in: general PSA analysis, what is it, and what is it for?

A general PSA blood test is a laboratory test that is carried out to determine the amount of prostate specific antigen (or PSA for short).

It is a protein that is synthesized in the male organ – the prostate.

If the level of this substance is elevated, this indicates that the prostate is not functioning properly. Moreover, this is not necessarily a cancerous tumor. A normal inflammatory process may also occur -. In any case, an increase in concentration indicates that the man needs to undergo a thorough examination.

What is it needed for?

The PSA test and its results are needed by the urologist to determine further actions in diagnosing or treating the patient. At the European Prostate Center this analysis included in the list of standard procedures.

The PSA test is used for:

• early diagnosis of prostate cancer;
• early detection of inflammatory processes and prostate adenoma;
• timely diagnosis of relapses of prostate malignancies. In this case, the analysis is performed after surgery;
• assessing the effectiveness of an oncology treatment regimen;
• prevention of malignant and benign prostate diseases.

There is no need to refuse PSA analysis. Its price is low. The results make it possible to identify deviations in time and eliminate them.

What conclusions can be drawn based on the results?

The male body is designed in such a way that the prostate increases in size with age. Along with this, the PSA indicator is also growing. Therefore, when the urologist studies the analysis, he takes into account what age category the patient belongs to.

Standard values ​​depending on age are given below:

• if a man is under 40 years old, the result should not normally exceed 1.4 ng/ml;
• from 40 to 49 years, the absence of pathology is indicated by a value of 2.5 ng/ml;
• men 50-59 years old can rest assured about their health if PSA is 3.5 ng/ml;
• at the age of 60 to 69 years, the standard is 4.5 ng/ml;
• in the period from 70 to 79 years, PSA in the blood should not exceed 6.5 ng/ml.

As for oncology, many doctors are wary if the PSA value in the blood of a 45-55 year old man is above 4 ng/ml. But it should be noted that with benign prostate adenoma, test results also often exceed 4 ng/ml.

When diagnosing oncology, the PSA test is used as a tumor marker. The ratio of free PSA to total is expressed as a percentage. If total PSA is 5.54 ng/ml and free PSA is 0.98 ng/ml, then the percentage of free PSA is 18. The norm is more than 15%. The lower this percentage, the higher the chances that an elevated total PSA level is caused by cancer. Therefore, if the value is below 10-15%, then the urologist is obliged to refer the patient for MRI, TRUS and biopsy. After removing the prostate and all tissues that are affected by metastases, the PSA test results show zero. But this does not mean that you can calm down and no longer conduct analysis.

After some time, the doctor orders a test again to make sure that the cancer has not started to grow again. If, during a subsequent study, the PSA level increases, this gives the right to suspect that there are tissues left in the body that are affected by cancer.

To make an accurate diagnosis, urologists pay attention not only to the PSA level, but also to other parameters of this test. For example:

• the rate at which PSA increases. To do this, compare blood tests done at different times;
• ratio of bound to free PSA.

Deviations from the standard indicate that there is a possibility of cancer. Therefore, the doctor prescribes a number of additional examinations. For example:

• rectal examination;
• MRI of the prostate;
• TRUSY.

If the results of these tests show abnormalities, then the urologist will refer the patient for a prostate biopsy.

Only a competent, experienced urologist can correctly interpret the results of a PSA test. Therefore, you should contact trusted clinics.

Does a high PSA always indicate cancer?

Rarely, but still there are patients who, with a normal or low PSA value, have a risk of cancer. This is approximately 1% of all cases. As practice shows, this happens with the development of an aggressive form of prostate cancer.

Prostate cancer

Studies by American scientists have shown that if the PSA level is below 4 ng/ml, then the probability of detecting prostate cancer during a biopsy is 15%. If the test results show PSA from 4 to 10 ng/ml, then the risk of cancer is 25%.

When PSA in the blood is above 10 ng/ml, then the chance of detecting prostate cancer increases to 50%. As the PSA value further increases, the risk of malignant disease also increases.

German urological clinics keep statistics on detecting prostate cancer with high PSA levels. The statistics are based on a survey of 2267 patients.

According to it, with PSA less than 2 ng/ml, the probability of cancer is 7.1%. If the value is between 2-3.9 ng/ml, the risk of pathology is 18.7%.

With levels ranging from 4 to 5.9 ng/ml, cancer was observed in 21.3% of cases. With PSA from 6 to 7.9 ng/ml, the disease occurred in 28.6%. When the results vary from 8 to 9.9 – 31.7% that the patient has cancer.

At a level of 10 ng/ml, the risk increases to 56.5%. In this case, osteoscintigraphy of skeletal bones is indicated. If the total PSA is above 200 ng/ml, this means that all organs and bone tissues of the skeleton are affected by metastases.

Don't panic or despair if PSA is slightly higher than normal. It is important to undergo additional examination. Poor results may be caused by certain medications or severe inflammation in the prostate gland.

How to donate blood correctly?

Various factors can affect the results of a PSA test. In Germany and Russia, the standards for passing the test are slightly different.

When conducting urological examinations in domestic clinics, the following rules are adhered to:

• It is allowed to donate blood for a PSA test no earlier than a month after the prostate biopsy;
• if the patient has undergone a course of antibiotic therapy, the test can be performed 4 weeks after completion of treatment;
• It is not necessary to donate blood on an empty stomach. But it is advisable to avoid eating fatty foods on this day;
• a couple of days before the examination, you need to avoid sexual activity and physical activity;
• You should not expose your body to emotional stress several hours before the analysis.

By following these simple rules, you can get the most accurate PSA test results.

How often should I do a general PSA test?

The examination is carried out using various medical equipment. But the most modern and accurate at the moment is PSMA PET CT.

The study allows us to identify even minor foci of the spread of malignant prostate cells.

German urologists advise men who are over forty years old and who have close relatives with prostate cancer to undergo a test to detect PSA levels in the blood every year. If a prostatectomy was performed, then the test will have to be taken regularly for several years.

This will help prevent relapse of cancer. Doctors recommend donating blood for a general PSA to all males over 45 years of age. Especially those who have been diagnosed with prostatitis. If there is a suspicion of the development of prostate cancer, the analysis should be carried out earlier than planned. The signs of a malignant tumor are similar to those of an adenoma.

Prostate cancer manifests itself:

• intermittent urination;
• frequent urge to go to the toilet;
• the presence of blood clots in semen and urine;
• a feeling of fullness of the bladder even after it has been completely emptied.

As the tumor grows, the symptoms become more pronounced. There are pains in the lower abdomen, in the groin area and erectile dysfunction. With metastasis, aching pain in the bones, anemia, and swelling are observed lower limbs, enlarged lymph nodes in the groin area. Men with prostate cancer also lose weight rapidly.

It is better to undergo the test regularly, since in the early stages the pathology is asymptomatic. Timely diagnosis allows you to detect the disease at the beginning of its development. Properly selected and timely therapy gives a high chance of complete recovery.

Video on the topic

Urologist about the PSA test:

Thus, the general PSA blood test is an important tumor marker that is used for the early diagnosis of prostate cancer. In order to detect pathology in time, you should undergo a preventive test and examination by a urologist annually. If cancer is diagnosed and treated at an early stage, the patient has a high chance of recovery. But it should be noted that poor PSA values ​​do not always indicate the presence of a malignant tumor. Such results can be observed with prostate adenoma or an inflammatory process. To make an accurate diagnosis, urologists prescribe a test for the ratio of total and free PSA. If necessary, MRI, TRUS, ultrasound and biopsy are also performed. To identify the correct diagnosis, it is important to contact a good, competent doctor.

IN Lately Unfortunately, prostate diseases have become one of the most common problems with men's health. Diseases of this organ, common and rare, bring a lot of inconvenience and discomfort to men, and sometimes pose a threat to life.

One of the criteria for diagnosing various prostate pathologies is a general and free PSA test. The normal level of prostate specific antigen in the blood of a healthy man is from 0.2 to 4 ng/ml.

PSA: origin and function in the body

To understand the importance of PSA test values, you need to understand what this substance is and where it comes from in male blood.

Prostate specific antigen is a protein in nature and is produced by the epithelial cells of the prostate tubules. Synonyms for its name are tissue kallikrein-3, gamma seminoprotein, prostate antigen. Functionally, it is an enzyme (serine protease) that dilutes sperm, irrigates the urethra (urethra) before ejaculation and dissolves cervical mucus (entering the vagina from the cervix in women), facilitating the easy passage of sperm into the uterine cavity.

In semen, the prostate antigen level is 1 mg/ml. And in the blood, as mentioned above, it is 4 ng/ml. To make the difference in the content of this substance clear, remember that 1 mg is 1,000,000 ng. The low blood level of gama-semiprotein is explained by the presence of a special barrier that does not allow it into the blood.

With the development of various pathological changes in the prostate, the vascular permeability of this organ increases, and the tissue-blood barrier reduces its effectiveness. Because of this, prostate proteins, including prostate antigen, enter the male blood serum.

Forms and norms of PSA

Doctors and laboratory technicians sometimes write incomprehensible words in their documentation. For example, as a result of a blood test: total PSA, free PSA - what is it?

Prostate antigen is present in two types:

• free PSA – not bound to any other proteins;
• bound PSA – bound to the carrier protein alpha1-antichymotrypsin.

Together, these two forms represent the total PSA. It is to determine this form that tests are taken when there is a suspicion of prostate disease. If the level of total prostate antigen is elevated, an additional study is prescribed to determine the free fraction of this protein. A prerequisite for obtaining accurate test results is that total and free PSA be determined from one blood sample.

The ratio of total and free PSA in blood serum is as follows:

Total PSA = free fraction + bound fraction.

The proportion of free PSA is only 10%, the rest is associated with prostate antigen.

For men of different ages, there are corresponding standards for the content of tissue kallikrein-3. Along with the entire body, the epithelial cells of the prostate also age. Because of this, the level of gamma semiprotein in the blood increases.

To be precise, the age standards indicated above are reference book data. In practical medicine, urologists consider the following values ​​to be the upper level of normal in male blood serum up to 50 years of age:

• Total PSA – norm 4 ng/ml;
• Free PSA – normal 0.04-0.5 ng/ml;
• Bound PSA is the norm 3.5-3.96 ng/ml.

Read also: What is a biopsy and how is it performed?

Indications for PSA analysis and reasons for its increase

Prostate problems can occur in men of any age. But most often this happens after 40 years. Therefore, upon reaching this age, each representative of the stronger sex should undergo a blood test for prostate antigen levels at least once a year for the purpose of preventive examination.

At a young age, men usually come to the urologist if any signs of the disease occur. Similar symptoms include:

• frequent night urination;
• feeling of incomplete emptying of the bladder;
• pain when urinating;
• partial excretion of urine.

The doctor performs a digital rectal examination of the prostate gland to determine its consistency. If lumps are present, a number of instrumental and laboratory tests are prescribed, including a blood test for prostate antigen.

An increase in the level of this protein can be due to various reasons. First of all, these are various types of pressure and effects on the prostate. These may include: recent ejaculation, digital examination, transrectal ultrasound, cystoscopy or insertion of a catheter into the bladder, taking organ tissue for biopsy. Pathological reasons for an increase in the content of this antigen include:

• benign prostatic hyperplasia (BPH);
• prostate carcinoma (cancer);
• inflammation of infectious origin;
• ischemia of the prostate vessels;
• prostate infarction.

If an excess of the prostate antigen norm is detected, the doctor will necessarily show oncological alertness and conduct additional examination, which is necessary if prostate cancer is suspected.

Increased levels of blood gamma-semiprotein:

• 4-10 ng/ml – suspicion of prostate carcinoma. This is the “gray area” of the concentration of a given protein. This level of prostate antigen indicates a high risk of developing any pathology of this organ, including oncology.
• 10-20 ng/ml – high risk of prostate carcinoma.
• Above 40 ng/ml – may indicate the presence of metastases.

If there is an elevated level of total prostate antigen, additional laboratory testing is prescribed. Now a new analysis is being evaluated: total and free PSA in one portion of blood. This is necessary to determine the nature of the process in the organ: benign or malignant. The ratio of antigen fractions in different pathologies is not the same. During the cancer process, the level of bound PSA increases and the level of the free fraction decreases. This is an important diagnostic sign: with prostate cancer, the level of free PSA is much lower than with a benign process and in a healthy state.

If the prostate antigen level is 4-10 ng/ml, a biopsy is not taken without the results of other studies. These values ​​are considered ambiguous and require additional examination methods and repeated testing. A content of 10-20 ng/ml may be an indication for a biopsy.

Recently, cases of detection of prostate carcinoma with normal levels of kallikrein-3 have become frequent. This indicates the need for mandatory use of additional methods for diagnosing prostate cancer. These include: transrectal examination, ultrasound, MRI, CT, determination of the rate of change in the concentration of gamma-semiprotein in the blood, tissue biopsy.

The urgency of the problem of increasing urological morbidity among men of active age has been gaining momentum in recent years, despite all the achievements of modern medicine. The need for early diagnosis and prevention of these diseases is only increasing. Prostate PSA analysis is one of the effective, accessible, informative methods with which you can detect signs of prostate adenoma or cancer. Oncology in the male reproductive system is one of the most pressing problems in diagnostic medicine.

This diagnosis is considered a kind of nightmare that awaits almost all men after forty years. Is this really so and what can be done to avoid prostatitis, cancer and prostate adenoma?

Prostatitis is an inflammation of the male, secretory active gland, which is located, as if enveloping the urethra from the outside, as it exits the bladder. It participates in the formation of sperm by secreting prostatic juice into the seminal fluid. Inflammation or degeneration of prostate tissue leads to an increase in its size. The consequence of this process is compression of the lumen of the urethra, impaired urination, and erectile dysfunction.

You can diagnose the inflammatory process of prostate tissue by seeking help from a urologist. To do this, the doctor will conduct all the necessary examinations. Typically, a research plan consists of the following steps:

• interview and examination of the patient;
• ordering laboratory tests;
• obtaining results and evaluating data;
• prescription of treatment.

Depending on what disease was detected during the examination (acute or chronic), treatment tactics are determined.

Laboratory methods used for the diagnostic stage inflammatory diseases prostate:

The list of laboratory data is supplemented by the results of instrumental methods, such as ultrasonography, tomography.

General PSA blood test

A significant scientific and diagnostic breakthrough in the late 1980s was the discovery of prostate-specific antigen, found in the bloodstream. Determining this indicator has made it possible to develop a lot of techniques that help in early diagnosis cancer, adenoma and other pathologies of men's health.

A general PSA blood test for prostatitis is already a common norm at the diagnostic stage. To determine it, a biochemical laboratory is required, which is available in almost all medical institutions.

Determination of PSA (what is it)

PSA is a protein substance, a glycoprotein, which is found in the blood of men and the ratio of its fractions determines the presence or absence of a cancerous, precancerous or pathological condition of the prostate of another nature.

Prostate tissue is the site of production of this substance, the functional purpose of which has not yet been fully studied. But the participation of PSA in the dilution of seminal fluid has already been clarified. The substance is present in the body of a healthy man in the form of prostate-specific antigen in small quantities. Based on observations and long-term study after the discovery of this unique element, content standards were developed, increased and decreased limits were clarified, and the relationship of the indicator with the presence of tumor, inflammatory and other pathological changes in prostate tissue.

The total amount of PSA consists of a substance that is in a free state and a bound fraction. It is the ratio of these two components to each other that is called the index, which can characterize the current pathological process.

The indicator reaction is based on the mechanism of binding of an antigen to a specific antibody. It is clear that we cannot see this process directly. Therefore, in order to assess exactly how the substances will combine with each other, an indicator is added to the complex, which produces a glow. The intensity of the glow reflects binding activity. Thus, it is possible to record a normal PSA level or whether it has deviations from the norm, and interpret the results.

The influence of the inflammatory process on the PSA index

Modern medical reference books contain explanations on the levels of certain substances or blood parameters. PSA is normalized in men from 0 to 4 ng in 1 ml of blood. Receiving such numbers means only one thing – the body is healthy. Exceeding the specified amount occurs with a pronounced inflammatory process, and not only in the prostate gland. It could be respiratory viral infections, inflammation of other organs, taking certain groups of drugs that negatively affect the PSA index.

If there are no longer any signs of a pathological process inside the prostate, then the right decision would be to remove all suspicions with a repeat analysis at intervals of up to two weeks. It's at the stage primary diagnosis. If it is necessary to check the treatment of prostatitis or adenoma, a tumor of the gland, then a control analysis is also carried out during therapy and after its completion. The next time you need to donate blood is no earlier than two weeks later.

Indications for the study

It is advisable to carry out a blood test for prostatitis for PSA levels in any case. But there are conditions or pathologies when donating blood to determine the content of this substance is necessary in order to accurately determine the diagnosis in unclear situations in order to predict further treatment or rehabilitation tactics. In this case, analysis is indicated for the following groups of people:

• men over forty years of age;
• convalescents after radical antitumor treatment;
• patients who are suspected of having a prostate tumor;
• for men after a course of treatment of adenoma, prostatitis to monitor the effectiveness of therapy.

Despite the undoubted advantages of the method, it is necessary to take into account many subtleties when deciphering its results, associated factors and the correct preparation for donating blood for PSA.

Preparing for the test

Blood is a tissue of the body, the state of which it reflects. That is why you can take it for analysis and determine the degree of disorder of other functions. The research is carried out “in vitro”, that is, outside the human body, “in glass”, literally. Therefore, preparation is essential to obtain objective data.

It is necessary to pay the most attention to the following requirements:

• The last meal and drinks, except water, are allowed no later than 8 to 9 hours before the study.
• There should be no sexual activity for a week.
• An examination by a urologist should be either after the analysis or 10-14 days before it.
• Any mechanical impact on the urethra or prostate automatically delays the analysis by at least two weeks.
• A few days before the planned study, stop drinking alcohol and smoke as little as possible.

All of the above measures will help to obtain an accurate, reference, adequate result, which will help in the diagnosis, treatment and rehabilitation of the patient.

Indicators and their interpretation

Total PSA consists of a fraction of free and bound substances. It is the level of free antigen that indicates the presumptive nature of the pathology. The normal value is considered to be from 0 to 4 ng in 1 ml of blood. This is a good result, indicating a completely healthy body.

The option in which the obtained values ​​are in the range from 4 to 10 ng in 1 ml is no longer so favorable. This is an indicator of the presence of inflammatory changes in the tissues of the gland itself, adenomatous growths, and a possible incipient malignant process.

Exceeding the value of 10 ng/ml forces you to pay close attention to the oncological nature of problems with the prostate gland. This result must be objectified by determining free PSA separately: the larger its proportion, the greater the chance that the tumor is benign.

Contraindications for the study

The patient may refuse a PSA blood test. There are no other contraindications to this test. This is the usual standard for a complete examination when prostatitis, adenoma or prostate cancer is suspected. You just need to prepare properly to get an objective result.

False result

You can get a false positive result in some cases, you need to know about them in order to avoid such an outcome:

• sexual intercourse on the eve of blood donation;
• examination by a urologist shortly before the analysis;
• biopsy examination of prostate tissue;
• bladder catheterization for difficulty urinating;
• eating food, alcohol, sweet drinks later than 8-9 hours.

The patient needs to be explained all these subtleties, which may negatively affect the correctness of the result.

This goal must be set, but not in order to reduce the level of the indicator, but to obtain positive dynamics in treatment. A decrease in PSA will indicate this.

Medicines

The effect of reducing prostate-specific antigen is achieved by taking the following drugs:

• 5-alpha-reductase inhibitors, which are used in the treatment of adenoma. Among them are such as “Dutasteride”, “Finasteride”.
• Thiazide diuretics are not etiological drugs for the treatment of prostate diseases, but with long-term use they reduce blood PSA.
• Cholesterol-lowering statins, when taken long-term, lower PSA levels.

Medicines should not be self-prescribed.

Folk remedies

Usage traditional medicine helps in the treatment of prostate diseases, as evidenced by a decrease in PSA when using the following drugs:

1. Bee products: honey, recipes based on it, propolis, pollen.
2. Herbs that reduce inflammatory reactions: chamomile, mint, sage, St. John's wort, oregano, celandine, yarrow, lungwort, calendula.
3. Flax seeds, nuts. They are rich in polyunsaturated fatty acids, which strengthen blood vessels, reduce cholesterol, normalize blood flow and filtration in the renal tubules.
4. Plants with poisonous properties: fly agaric, hemlock, chaga, aconite. They have a detrimental effect on cancer cells and help remove them from the body.

Price folk remedies quite low, but in combination with adequate drug therapy non-traditional recipes give a good effect. It is not uncommon to have surgery to treat the prostate, which also results in a return of PSA levels to normal levels.

Prevention of PSA elevation

All men need to take care of their health, and not only after forty years. To do this, you should eat rationally, avoid alcohol, smoking, not to mention drugs.

Orderly, regular sex life, preferably with regular partners, will protect against pathogens from entering the prostate tissue. You should also promptly seek qualified help if you suspect sexually transmitted diseases. The doctor will not only prescribe the necessary treatment, but will also conduct an ultrasound and other important examinations of the pelvic organs. The tips are quite simple, but their price is very high - men's health.

You may also be interested

Details about laboratory diagnosis of prostatitis
Diagnostic measures to detect inflammation of the prostate