Distribuição dos valores do antígeno prostático específico em pacientes com hiperplasia prostática benigna e câncer prostático e em indivíduos sadios

Abstract

Benign prostatic hyperplasia (BPH) and prostatic adenocarcinomas (PC) are among the most common pathologies of Brazilian adult men. The preliminary diagnostic criteria most used forthese pathologies include digital rectal examination (DRE), and measurement of serum prostate specific antigen (PSA). The aim of the present studies was to evaluate the distribution of total serum PSA leveis (PSA-st), in patients with confirmed diagnosis for prostate pathologies, and the influence of DRE on the PSA-st leveis in healthy adult men; as also the normal leveis of PSA-st in healthy adult males. Of the 147 patients studied, 85 (58.6%) had HPB, and 62 (41.4%) were diagnosed with PC. In the patients with HPB, the PSA-st values varied from 0.01 to 83.00 ng/mL; with a mean value of 9.43 ± 10.30 ng/mL, and a median value of 7.70 ng/mL. Sixteen of these patients (18.8%) revealed PSA-st leveis below 4.00 ng/mL; while in 22 (25,9%) the values were higher than 10.00 ng/mL; indicating that 44.7% of the patients diagnosed for HPB had PSA-st leveis outside the range considered suggestive of this pathology. The PSA-st leveis of 62 patients with prostatic câncer were generally higher than those for HPB; with the values ranging from 0.01 and 500 ng/mL, and median and mean values, respectively, of 13.40 and 38.90 ± 85.11 ng/mL. Twenty two (32.3%) of the cases of PC had PSA-st values below 10 ng/mL; while four (6.2%) revealed leveis between 129 and 500 ng/mL. The median values of the patients with HPB and PC were highly significantly different (p < 0.001). In both the pathologies, the PSA-st leveis increased with higher age; but the median values among the age groups were not statistically significant, either in individuais with HPB or in PC patients (p >0.05). DRE carried out in 48 healthy males, induced only modest, and non-significant, elevations in PSA-st leveis in a minority. A normal adult male population of 469 individuais revealed mean and median PSA-st values of 2.40 ± 4.30 ng/mL and 1.20 ng/mL; respectively; with the values increasing in higher age groups. The median values among the age groups were significantly different (p < 0.001). Our observations on the PSA-st values of patients with confirmed diagnosis suggest that the PSA-st values show a quantitative relation, in general, with each of the pathologies; without revealing distributions of values that enable a definite characterization of either HPB or PC.