Deciphering PSA: blood test, indicators, norm, pathology and age-related features

Currently, in medicine, much attention is paid not only to the treatment of diseases, but also to the diagnosis of their development in the early stages. This allows you to start therapy in a timely manner, which will significantly increase the chances of recovery. This is especially true for cancer, in which delay in treatment can lead to serious consequences. In men, one of the methods for diagnosing prostate cancer is to study PSA in a blood test. The decoding and norm of values ​​will be discussed in the article.

Definition

PSA is a prostate-specific antigen. It is a protein produced by the prostate gland. It is a component of sperm. The main function of PSA is to dilute sperm to ensure free movement of sperm to the egg.

This protein enters not only the ejaculate. A very small amount of it is in the blood. If a man develops an inflammatory process, the prostate gland begins to produce an increased amount of PSA, which is why the analysis and reveals a pathological change in the level of this protein in the blood.

The following forms of a specific protein are distinguished:

• Common. It is prescribed most often, since it can indicate an early stage of the development of pathology.
• Free. It is prescribed less often, in most cases, to clarify the diagnosis.
• Connected.

Various external factors (for example, recent prostate massage) and benign diseases can affect the level of total PSA. In this regard, in some cases, to confirm the oncological diagnosis, a blood test is prescribed for the level of free PSA, the values ​​of which with a malignant formation will be reduced.

Norms

To study the level of antigen in the blood, venous blood is used, which is taken in the morning on an empty stomach.

When deciphering PSA in men, specialists rely on those standards at which the age factor is taken into account. This is due to the fact that in men after 50 years of age, the size of the prostate gland increases. This fact suggests increased PSA blood test rates.

The interpretation will also depend on the presence of external factors, which the laboratory technician needs to be told about before analysis. This may be a violation of preparatory recommendations, taking certain medications and more.

Most experts came to the conclusion that in men under the age of 50 years, the norm in decoding PSA analysis should not exceed 3 ng / ml. But some of the doctors are of the opinion that at this age, the level of protein in the blood should not be higher than 2.5 ng / ml. Increasing the values ​​to 3 ng / ml should be the reason to take additional tests to exclude the development of the oncological process.

At present, it is customary to use age decoding in the analysis of PSA in men. The table of normal values ​​is given below.

It should be noted that when decoding the analysis of the general PSA, a zero value can also be the limit of the norm.

Diagnosis of low levels of antigen in the blood of a man indicates a minimal risk of development of pathological conditions in the prostate gland. In the absence of pathological symptoms, there is no cause for concern in this case.

It is not necessary to independently decipher PSA in the blood, since only the attending physician after a comprehensive diagnosis can deliver the exact result.

Indications for analysis

Initially, an analysis for the presence of PSA in the blood of a man was prescribed only if a malignant formation of the prostate gland was suspected. But at present, experts have begun to use PSA decryption to diagnose benign formations in the prostate (for example, adenomas).

The most common indications for analysis are:

• Suspicion of the presence of a tumor of both malignant and benign nature.
• Prevention of neoplasms of a different nature in men after 40 years.
• Monitoring the level of antigen in patients who underwent radiation therapy. It is recommended that a re-examination be carried out every 3 months.
• Observation of the possible growth of malignant prostate gland. As a rule, in this case, the PSA level is watched in dynamics. The rate of increase in antigen levels in the blood depends on the rate of development of the malignant tumor.
• Evaluation of the effectiveness of treatment for prostate cancer.

Also, the doctor may decide on the appointment of the described analysis with the following patient complaints:

• On palpation, an enlargement of the prostate gland is felt.
• Frequent urination. In this case, pain and burning sensation can be felt.
• Decreased desire and sexual activity.
• Pain in the groin, which can give to the lower back.
• Erectile dysfunction.

Analysis for PSA is recommended to be systematically taken to people whose history has a hereditary factor or harmful working conditions.

Analysis preparation

To obtain accurate results when decoding PSA in the blood, the correct preparation is of great importance, since the antigen is very sensitive to the influence of external factors.

The following rules are recommended:

• Food restriction. Do not eat or drink 10 hours before analysis.
• About a day to refuse tea, coffee, juice. Do not smoke.
• 3 days before blood donation, do not eat fatty, smoked, salty foods.
• Do not drink alcohol 4-5 days before analysis.
• For 5-7 days, refrain from intimacy.
• After a massage of the prostate, ultrasound diagnostics performed by the rectal method, as well as after a digital rectal examination, analysis can be taken in a week.
• After a prostate biopsy, blood donation for PSA should be done no earlier than a month after the procedure.
• If at the time of the analysis the patient is taking any medications, it is necessary to notify the laboratory assistant.

Additional examinations

Deciphering the analysis of total PSA is not enough to make the correct diagnosis. Often you need to take into account the level of PSA free. This happens when doubts arise about the nature of the pathological process. In this case, PSA total and PSA free are measured. The interpretation of the obtained values ​​reveals the ratio between these two indicators, which is calculated as follows: PSA free / PSA total x 100%. If the result is more than 25%, then we can talk about the benign nature of the pathological process. In the case when a ratio of less than 10% is detected, a malignant process in the prostate gland develops. It is necessary to conduct additional examinations, which include the following laboratory and instrumental studies:

• A clinical blood test in which special attention will be paid to the level of leukocytes and the erythrocyte sedimentation rate (ESR). An increase in these indicators indicates the presence of an inflammatory process in the body.
• Determination of PSA density. In this case, the ratio of the weight of the prostate gland (a characteristic can be detected by ultrasound examination) and the level of total PSA plays a role. An increase in density may indicate the development of a malignant process occurring in the patient's body.
• Ultrasound of the prostate gland, in which pathological changes in the organ can be detected.
• Biopsy. It is prescribed for the detection of PSA more than 10 ng / ml and for the detection of even minor seals in the prostate gland upon palpation.
• TRUS (transrectal ultrasound diagnosis). Allows to distinguish the benign nature of the pathological process from the malignant.

Reasons for the increase

Deviations from the norm in the decoding of the PSA analysis associated with an increase in the values ​​do not always indicate a malignant formation. Consider some of the most common causes of increased levels of specific antigen in the blood:

• Benign formation of the prostate gland (adenoma).
• Potency problems.
• Surgical intervention (for example, after removal of the adenoma).
• Infectious processes in the prostate gland.
• Inflammatory processes.
• Groin injuries.
• Mechanical stress (e.g. massage, cystoscopy).
• Non-compliance with sexual rest (before the analysis there was an ejaculation).
• A ride on the bicycle.
• Prostate infarction.
• Enlarged prostate gland as an individual feature of the patient.
• Taking medications that increase testosterone.

Table of possible values ​​for pathologies

The presented table includes averaged values. The final diagnosis is made by the attending physician on the basis of examination and obtaining the results of all prescribed tests.

It is worth noting that in patients who underwent prostatectomy (removal of the prostate gland), the level of PSA in the blood should be equal to 0.

Values ​​from 4 to 10 ng / ml are borderline indicators at which it is impossible to speak with confidence about the benign or malignant nature of the pathological process. In this case, it is necessary to carry out a number of additional diagnostic measures.

Causes of Antigen Growth

The reasons for the increase in antigen in different diseases are slightly different. Let's consider in more detail.

• In inflammatory processes in the prostate, an increase in PSA is due to impaired tissue patency.
• With adenoma, the volume of the gland increases and compression of its cells by adenomatous tissue is observed.
• Also, with an adenoma, an acute delay in the passage of urine is possible, which can lead to slightly higher values ​​of the PSA level in the blood.
• In prostate cancer, an increase in antigen occurs for two reasons: due to its production by cells of a malignant formation and the destruction of the barriers of the gland membrane.

Free PSA

The interpretation of the analysis of free PSA is somewhat different from the general one. With a malignant process in the prostate gland, its level will decrease relative to the norm. With a benign tumor, elevated levels of free PSA are diagnosed. The normal values ​​in this case are indicators of 0.93 ng / ml.

The level of this form of antigen in the patient’s blood is in most cases specified if it is necessary to confirm the diagnosis or to evaluate the result of the treatment of a malignant tumor. For example, if the analysis revealed an indicator of less than 15%, then we can talk about an unfavorable prognosis. If the values ​​are in the range from 15 to 70%, the chances of recovery are quite high.

Indications for analysis for free PSA

• Observation of patients diagnosed with prostate cancer. Held in dynamics.
• Diagnosis of oncology, adenoma or prostatitis.
• Monitoring a patient with a diagnosis of adenoma. It is carried out with the aim of early diagnosis of possible malignancy.
• Preventive measures for men after 45 years.

Prostate Cancer Treatment

If the increase in PSA in the blood of a man is caused by an oncological process in the gland, the doctor can use the following methods in treatment, depending on the stage of the cancer and the general condition of the patient:

• Radiation therapy. The most common treatment method in which the affected organ is irradiated.
• Brachytherapy Used in the absence of metastases. It is a type of radiotherapy. This is an effective type of treatment, which eliminates the negative impact on healthy tissue.
• Prostatectomy A radical method that is used in the absence of the results of another treatment. It is an operation in which the prostate gland, nearby lymph nodes and testes are completely removed.

After the therapy, it is necessary to systematically monitor the PSA level to confirm the effectiveness of the treatment measures and to exclude the possibility of relapse.

Conclusion

The state of health to a large extent depends on the person himself. Oncological diseases can develop rapidly, so it is so important to diagnose them at an early stage, in this case the chances of a full recovery are quite high. Prostate cancer has a high mortality rate, so you should not neglect planned visits to the doctor, especially after reaching 40 years of age and having a history of hereditary factor.

A blood test for PSA and its interpretation are of great diagnostic value. To get an accurate result, you must follow all the recommendations. With a timely visit to the doctor and passing all the necessary tests, it is possible to identify diseases of the prostate gland in the early stages, which will increase the chance of a successful recovery and prevent the development of relapse. Deciphering the analysis of PSA in men is performed by the attending physician.