Low Levels of Urinary PSA Better Identify Prostate Cancer Patients

[pjoshea13]

New Italian study below [1].

While men with undiagnosed PCa have increasing levels of blood PSA, urinary levels paradoxically fall.

Higher blood levels may also be due to BPH (80% of biopsies are negative), but lower urinary levels appear to be more specific for PCa.

A urine test might considerably reduce the number of unnecessary negative biopsies. (I wonder how the test would adjust for dehydration?}

Blood tests would still be needed to monitor treated men.

-Patrick

[1] pubmed.ncbi.nlm.nih.gov/342...

Cancers (Basel)

. 2021 Jul 16;13(14):3570. doi: 10.3390/cancers13143570.

Low Levels of Urinary PSA Better Identify Prostate Cancer Patients

Sergio Occhipinti 1 2 , Giulio Mengozzi 3 , Marco Oderda 4 , Andrea Zitella 4 , Luca Molinaro 5 , Francesco Novelli 1 , Mirella Giovarelli 1 2 , Paolo Gontero 4

Affiliations collapse

Affiliations

1 Department of Molecular Biotechnologies and Health Sciences, University of Turin, 10126 Turin, Italy.

2 NIB Biotec srl, 10135 Turin, Italy.

3 Clinical Biochemistry Laboratory, Department of Laboratory Medicine, AOU Città della Salute e della Scienza di Torino, 10126 Turin, Italy.

4 Division of Urology, Department of Surgical Science, AOU Città della Salute e della Scienza di Torino, University of Turin, 10126 Turin, Italy.

5 Division of Pathology, AOU Città della Salute e della Scienza di Torino, 10126 Turin, Italy.

PMID: 34298784 DOI: 10.3390/cancers13143570

Abstract

Serum prostatic specific antigen (PSA) has proven to have limited accuracy in early diagnosis and in making clinical decisions about different therapies for prostate cancer (PCa). This is partially due to the fact that an increase in PSA in the blood is due to the compromised architecture of the prostate, which is only observed in advanced cancer. On the contrary, PSA observed in the urine (uPSA) reflects the quantity produced by the prostate, and therefore can give more information about the presence of disease. We enrolled 574 men scheduled for prostate biopsy at the urology clinic, and levels of uPSA were evaluated. uPSA levels resulted lower among subjects with PCa when compared to patients with negative biopsies. An indirect correlation was observed between uPSA amount and the stage of disease. Loss of expression of PSA appears as a characteristic of prostate cancer development and its evaluation in urine represents an interesting approach for the early detection of the disease and the stratification of patients.

Keywords: biomarkers; diagnosis; early detection; prostate cancer detection; prostate cancer prevention; screening.