Re-examination of abnormal PSA in patients with prostate cancer after prostatectomy

Prostate-specific antigen (PSA) is a single-chain glycoprotein encoded by the hKLK3 gene and secreted by prostate epithelial cells. Only trace amounts of PSA (0-4 ng/ml) can be detected in normal male serum.

In addition to diagnosing prostate cancer, PSA testing is also one of the commonly used examination methods for follow-up after radical prostatectomy. For patients who undergo radical prostatectomy, the probability of local tumor recurrence or distant metastasis within 10 years after surgery is about 27% to 53%. Therefore, it is generally recommended to have a PSA test every 3 months after discharge, every 6 months after 2 years, and once a year after 5 years.

When a patient's PSA index is abnormal, in order to prevent the recurrence of prostate cancer, other examination measures should be taken in time to determine the development of the disease.

1. After radical prostatectomy, if PSA is greater than 0.5 ng/mL, local nodules are found during rectal examination, or local hypoechoic lesions are found during transrectal ultrasound examination, a puncture biopsy is recommended.

2. For patients whose PSA levels increase by more than 0.75 ng/mL per month, bone scan and pelvic CT/MRI are recommended.

3. If the patient has bone pain, a bone scan should be performed to detect postoperative recurrence in a timely manner.

Tips: PSA of 0 is the gold standard for tumor-free status after radical prostatectomy

After radical prostatectomy to remove all prostate tissue, if the tumor is cured, the PSA level in the serum will drop to 0 within 1 month.