Study Of Serum And Tissue Concentrations Of PSA

Objective The aim of this study were: 1. To measure the expressions of PSAmRNA in different pathological tissues of BPH and prostate carcinoma, and correlate the tissue expressions of PSAmRNA with circulating levels of PSA. 2. To quantitative estimate PSA in BPH tissues with and without histologic prostatitis, and correlate the tissue concentrations of PSA with PSAD. 3. To evaluate the factors effect on circulating levels of PSA in patients with BPH.Materials and Methods A total of 47 specimens from patients with BPH underwent transurethral resection of prostate (TURP), and 18 tissue samples from patients with prostate carcinoma underwent transperineal fine needle aspiration biopsy, from Mar. 2008 to Mar. 2009, were collected. The distribution of TURP specimens was 14 with histological prostatitis and 33 without prostatitis. The distribution of biopsy samples were 5 had Gleason score 5-6, 9 had Gleason score 7-8,4 had Gleason score 9-10, and 3 from bone metastasis patients, 15 from bone metastasis free patients, respectively. Clinical parameters were obtained including age, prostate volume, serum tPSA and PSAD. Real-time RT-PCR was applied to measure the expressions of PSAmRNA in BPH and prostate carcinoma tissues. Sonication and chemiluminescence immunoassay (CLIA) were used to quantitative estimate PSA, immunohistochemistry stain and computer image analysis were used to measure the density of epithelium and excluded stromal elements in BPH tissues. The mean of groups were compared. The tissue expressions of PSAmRNA were correlated with serum PSA in each group of patients with BPH and prostate carcinoma, respectively. The tissue concentrations of PSA were correlated with PSAD in both groups of patients with BPH. Of the patients with BPH, 24 had serum tPSA≤4ng/ml and 23 had serum tPSA>4ng/ml;40 had serum tPSA≤10ng/ml and 7 had serum tPSA>10ng/ml. All clinical parameters and experimental data from patients with BPH were multiple analysised dependent on serum tPSA with cut point 4ng/ml and 10ng/ml, respectively. SPSS 13.0 was applied for statistical analysis, including t tests or Mann-Whitney U tests for mean comparisons, Pearson tests or Spearman tests for correlations, and binary logistic regressions for multiple analysis.Results The average expressions of PSAmRNA in prostate carcinoma and BPH tissues were 19.6820(SD26.06462) and 62.9069(SD129.33742)copies/unit-totalRNA, respectively. The former was lower than the latter but the difference didn't reach the statistical significant (P=0.159). The average expressions of PSAmRNA in BPH tissues with and without histological prostatitis were 73.7612(SD147.91038) and 58.3020(SD122.82347)copies/unit-totalRNA, respectively. The former was higher than the latter but the difference didn't reach the statistical significant (P=0.609). The average expressions of PSAmRNA in maginant tissues with Gleason score 5-6, 7-8, 9-10 were 20.6204(SD23.39525), 26.8350(SD30.99851), 2.4150(SD2.24355)copies/unit-totalRNA, respectively. The last one was significant lower (P=0.046). the average expressions of PSAmRNA in maginant tissues from bone metastasis and bone metastasis free patients were 3.9472(SD4.07306) and 22.8290(SD27.54829)copies/unit-totalRNA, respectively. The former was significant lower than the latter (P=0.023). Tissue expressions of PSAmRNA were significant correlated with circulating levels of PSA in patients without prostatitis (r=0.525, P=0.002). Tissue expressions of PSAmRNA were not correlated with circulating levels of PSA in patients with prostatitis or prostate carcinoma. The average tissue concentration of PSA in patients with and without prostatitis were 136420.16(SD92536.825) and 75174.27(SD99688.273)ng/g tissue or 0.360565(SD0.2258420) and 0.195959(SD0.2282488)ng/g tissue/%epithelium, respectively. The former was significant lower than the latter (P=0.048, P=0.028, respectively). Tissue concentrations of PSA were significant correlated with circulating PSAD in patients without prostatitis (r=0.602, P=0.000). Tissue concentrations of PSA were not correlated with PSAD in patients with prostatitis Prostate volume was identified as the factor effect on the elevated tPSA>4ng/ml, and tissue expression of PSAmRNA was identified as the factor effect on elevated tPSA>10ng/m in patients with BPH.Conclusions PSA production was significant lower in poor differentiated prostate carcinoma, and serum PSA wasn't related to production capability of PSA in patients with prostate carcinoma. Tissue content of PSA in patients with histological prostatitis was significant lower than that without prostatitis, and the difference of PSA quantitative per unit epithelium was more remarkable between two groups. Serum PSA was related to production capability and tissue content of PSA in patients without histological prostatitis. There were no relationships between serum PSA and production capability or tissue content of PSA in patients with histologic prostatitis. Elevated PSA>4ng/ml was due to prostate enlargement and elevated tPSA>10ng/ml was owe to strong production capability of PSA in patients with BPH.