The prognostic value of prostate-specific antigen and prostatic acid phosphatase in serum of patients with prostate cancer after orchidectomy

Effect of digital rectal examination on plasma prostate-specific antigen (PSA)

Presented are results of determination of plasma PSA before, 1 and 24 hours and 3 weeks after digital rectal examination (DRE) in 130 patients with prostatic adenoma (BPH). Mean pre-examination PSA level was 8.5 ng/ml (max. 27.0 ng/ml, min. 0.3 ng/ml, SD = 6.2). PSA rose at 1 and 24 hr. post-DRE: 9.4 ng/ml (max. 28.9 ng/ml, min. 0.5 ng/ml, SD = 6.7) and 10.7 ng/ml (max. 28.0 ng/ml, min. 0.5 ng/ml, SD = 7.9), respectively.

CONCLUSION

in patients with prostatic adenoma DRE is followed by a rise in plasma PSA, which returns almost to baseline values by 3 weeks.

Relationship between prostate-specific antigen, prostate volume, retention volume and age in benign prostatic hypertrophy (BPH)

The relationship between plasma PSA, prostatic adenoma mass (AM), retention volume (RV) and age was studied in 112 men with benign prostatic hypertrophy (BPH). Their age ranged from 48 to 85 years. Mean PSA was 6.9 ng/ml (SD 6.6) and did not exceed 10 ng/ml in 81.2% of the patients. Mean AM and RV were 66.2 g (SD 36) and 51.7 ml (SD 1.3), respectively. Increase in PSA level was influenced mainly by RV (r = 0.53) but was found to correlate weakly with AM (r = 0.34) which in turn showed low correlation with RV (r = 0.32). Age did not correlate with PSA, AM and RV (r > or = 0.1). AM and RV influence PSA levels independently and large inter-patient differences are well characterized by SD values.

The deiodination of thyroxine to triiodothyronine in the testes of patients with prostate cancer

Until recently metabolism and expression of thyroid hormones was considered not to occur in the tissues of the testes. Lately, specific receptors for triiodothyronine have been found in the nuclei of human testicular cells which shows that testicular tissue requires hormonal action [9]. The aim of the present study was to evaluate if the prohormone thyroxine is converted into triiodothyronine within human testes (resected because of prostatic carcinoma) and if hormonal therapy with dihydrostilbestrol (DES), a testosterone antagonist, affects production of the active thyroid hormone. Our earlier studies showed a complete lack of iodothyronine 5'-deiodinase activity in prostatic carcinoma (PC) [7]. The present material consisted of testes from 21 patients with PCs. According to Whitmore's classification 13 patients were at stage C with mean PSA of 70.15 ng/ml and 8 were at stage D with mean PSA of 308.73 ng/ml. Before castration 6 patients (3 stage C and 3 stage D) were pretreated with 3 mg DES daily for 3 days. The resected testes were homogenized and ultracentrifuged. The obtained microsomal fraction was the source of thyroxine 5'-deiodinase (T4-5'-D). In 15 patients, in whom the primary approach was surgical, the specific T4-5'-D activity was not different between stage C and D patients (mean +/- SD): 19.52 +/- 12.55 vs. 22.07 +/- 12.68 fmol de novo produced triiodothyronine/min/mg of microsomal protein, respectively. However, in 6 patients pretreated with DES the activity was significantly decreased, regardless of the degree of differentiation of the prostate carcinoma: 0.70 +/- 0.68 fmol T3/min/mg for stage C and 2.6 +/- 4.5 fmol/min/mg for stage D patients.(ABSTRACT TRUNCATED AT 250 WORDS)