Philadelphia, Pa.: Saunders Elsevier; 2016. http://www.clinicalkey.com. Medical Author: William C. Shiel Jr., MD, FACP, FACR; PSA: Prostate specific antigen. | PSA is a protein produced by both cancerous and noncancerous tissue in the prostate, a small gland that sits below the bladder in men.
AskMayoExpert. The PSA test is a blood test used primarily to screen for prostate cancer.The test measures the amount of prostate-specific antigen (PSA) in your blood.
Mayo Clinic does not endorse companies or products. Prostate cancer is common, and a frequent cause of cancer death. [24], No studies have been performed to assess the PSA levels in the tissues and secretions of pre-pubescent children. | Menu Search. Another common screening test, usually done in addition to a PSA test, is a digital rectal exam. [33], PSA was first measured quantitatively in the blood by Papsidero in 1980,[34] and Stamey carried out the initial work on the clinical use of PSA as a marker of prostate cancer. doi: 10.1371/journal.pone.0051735. [medical citation needed], Of those found to have prostate cancer, overtreatment is common because most cases of prostate cancer are not expected to cause any symptoms due to low rate of growth of the prostate tumor. PSA also is found in the serum of women with breast, lung, or uterine cancer and in some patients with renal cancer. The breast is a major female organ able to produce PSA. In: Ferri's Clinical Advisor 2016. 11th ed. © 1998-2020 Mayo Foundation for Medical Education and Research (MFMER). False-negative results can give men a false sense of security even though they may actually have cancer. American Pet Registry APDT. A single copy of these materials may be reprinted for noncommercial personal use only. In: Campbell-Walsh Urology. Prostate-specific antigen interacts with and activates the vascular endothelial growth factors VEGF-C and VEGF-D, which are involved in tumor angiogenesis and in the lymphatic metastasis of tumors. Mayo Clinic is a not-for-profit organization. [24] While traditional tests such as crossover electrophoresis have a sufficiently low sensitivity to detect only seminal PSA, newer diagnostics tests developed from clinical prostate cancer screening methods have lowered the threshold of detection down to 4 ng/mL. Goldman L, et al., eds. Most PSA in the blood is bound to serum proteins. What kinds of recommendations he or she might make if the results are positive, How often you should repeat the test if the results are negative. PSA is detected in both normal and abnormal breast tissues, as well as in various breast fluids including milk, nipple aspirate, and cyst fluid. PSA levels in serum also vary during menstrual cycles and increase in women with excess androgen.
[citation needed].
Therefore, the presence of PSA from a high sensitivity (4 ng/mL) test cannot conclusively identify the presence of semen, so care must be taken with the interpretation of such results. PSA level is one of three variables on which the risk-stratification is based; the others are the grade of prostate cancer (Gleason grading system) and the stage of cancer based on physical examination and imaging studies. If indicated, prostate biopsy is performed to obtain a tissue sample for histopathological analysis. These other methods are intended to improve the accuracy of the PSA test as a screening tool.
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See our safety precautions in response to COVID-19. [63][64]
The National Health Service does not offer general PSA screening, for similar reasons. Get the latest research from NIH: https://www.nih.gov/coronavirus. [failed verification] Since the expected harm relative to risk of death are perceived by patients as minimal, men found to have prostate cancer usually (up to 90% of cases) elect to receive treatment. Digital rectal examination (DRE) has been shown in several studies[42] to produce an increase in PSA. http://www.uptodate.com/home. PSA is a protein produced by both cancerous and noncancerous tissue in the prostate, a small gland that sits below the bladder in men.PSA is mostly found in semen, which also is produced in the prostate. [10] IGF binding proteins (IGFBPs) and regulation of breast cancer biology. More studies are needed to further explore their utilities. The risks include: A nurse or medical technician will use a needle to draw blood from a vein, most likely in your arm. Prostate-specific antigen (PSA, also known as kallikrein III, seminin, semenogelase, γ-seminoprotein and P-30 antigen) is a 34-kD glycoprotein produced almost exclusively by the prostate gland. Philadelphia, Pa.: Elsevier; 2016. http://www.clinicalkey.com. Receptor-recognized α₂-macroglobulin binds to cell surface-associated GRP78 and activates mTORC1 and mTORC2 signaling in prostate cancer cells. Philadelphia, Pa.: Elsevier; 2016. http://www.clinicalkey.com. Zinc ions have a strong inhibitory effect on the activity of PSA and on that of KLK2, so that PSA is totally inactive. [citation needed], Following radiation therapy of any type for prostate cancer, some PSA levels might be detected, even when the treatment ultimately proves to be successful. PSA is a member of the kallikrein-related peptidase family and is secreted by the epithelial cells of the prostate gland. J Mammary Gland Biol Neoplasia.
2012;7(12):e51735. The activity of PSA is well regulated. The relationship between early embryo development and tumourigenesis. Prostate Specific Antigen (PSA) Prostate Specific Antigen (PSA), a tumor marker for adenocarcinoma of the prostate, can predict residual tumor in the post-operative phase of prostate cancer. [27], PSA is normally present in the blood at very low levels. PSA is mostly found in semen, which also is produced in the prostate. On ejaculation, semen is exposed to the acidic pH of the vagina, due to the presence of lactic acid. PSA has been shown to be expressed ….
Ma Y, Zhang P, Wang F, Yang J, Yang Z, Qin H. J Cell Mol Med.
Clinical studies demonstrate that PSA in breast cancer is associated with the expression of estrogen receptor and progesterone receptor. [12] False-positive test results can cause confusion and anxiety in men, and can lead to unnecessary prostate biopsies, a procedure which causes risk of pain, infection, and hemorrhage. Its proteolytic action is effective in liquefying the coagulum so that the sperm can be liberated. 2010 Jun;33(6):437. doi: 10.1007/BF03346618. In fertile couples, the final vaginal pH after coitus approaches the 6-7 levels, which coincides well with reduced zinc inhibition of PSA. [54] Proteolytically active PSA has been shown to have an anti-angiogenic effect [55] and certain inactive subforms may be associated with prostate cancer, as shown by MAb 5D3D11, an antibody able to detect forms abundantly represented in sera from cancer patients. Types of Acronyms Acronym … "Mayo," "Mayo Clinic," "MayoClinic.org," "Mayo Clinic Healthy Living," and the triple-shield Mayo Clinic logo are trademarks of Mayo Foundation for Medical Education and Research. By feeling or pressing on the prostate, the doctor may be able to judge whether it has abnormal lumps or hard areas. PSA levels can be also increased by prostatitis, irritation, benign prostatic hyperplasia (BPH), and recent ejaculation,[40][41] producing a false positive result. A small amount is not protein-bound and is called 'free PSA'. PSA - What does PSA stand for? [35], Increased levels of PSA may suggest the presence of prostate cancer.
[27], Flocks was the first to experiment with antigens in the prostate[28] and 10 years later Ablin reported the presence of precipitation antigens in the prostate. USA.gov. [37] Delayed early detection may partially explain worse outcomes in obese men with early prostate cancer. However, the effect is clinically insignificant, since DRE causes the most substantial increases in patients with PSA levels already elevated over 4.0 ng/mL. [62], Prostate-specific antigen has been shown to interact with protein C inhibitor. Prostate cancer cells generally have variable or weak staining for PSA, due to the disruption of their normal functioning.
The risk of cancer increases if the free to total ratio is less than 25%. Discussing with your doctor the benefits, limitations and potential risks of the PSA test can help you make an informed decision. Please enable it to take advantage of the complete set of features! Small amounts of PSA ordinarily circulate in the blood.
However, many noncancerous conditions also can increase the PSA level. Measuring the activity of the enzyme could add to the ratio of free-to-total PSA and further improve the diagnostic value of test. [citation needed], PSA is produced in the epithelial cells of the prostate, and can be demonstrated in biopsy samples or other histological specimens using immunohistochemistry. In the United Kingdom, the National Health Service as of 2018[update] does not mandate, nor advise for PSA test, but allows patients to decide based on their doctor's advice. [61], Tissue samples can be stained for the presence of PSA in order to determine the origin of malignant cells that have metastasized. Medical Definition of PSA. If you decide that a PSA test is right for you, ask your doctor: Discussing these issues beforehand may make it easier for you to learn the results of your test and make appropriate decisions afterward. [24], In women, PSA is found in female ejaculate at concentrations roughly equal to that found in male semen. [29], In 1971, Mitsuwo Hara characterized a unique protein in the semen fluid, gamma-seminoprotein. PSA is produced for the ejaculate, where it liquefies semen in the seminal coagulum and allows sperm to swim freely. All Acronyms. | What does PSA stand for? [58][59], It is now clear that the term prostate-specific antigen is a misnomer: it is an antigen but is not specific to the prostate. NM_001030047NM_001030048NM_001030049NM_001030050NM_001648. [8], Clinical practice guidelines for prostate cancer screening vary and are controversial, in part due to uncertainty as to whether the benefits of screening ultimately outweigh the risks of overdiagnosis and overtreatment. J Gend Specif Med. Prostate-specific antigen production in the female breast: association with progesterone.
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