What are the markers for prostate cancer?

1. Total prostate-specific antigen (TPSA)

Mainly related tumors: prostate cancer.

Other related tumors: certain gynecological tumors, polycystic ovary syndrome, breast cancer.

Other influencing factors: prostatitis and prostatic hypertrophy can cause an increase.

PSA is a specific marker for prostate cancer and is currently the only recognized organ-specific tumor marker. An increase in serum TPSA generally indicates the presence of prostate lesions (prostatitis, benign hyperplasia or cancer). Serum PSA is one of the most important indicators for detecting and early detection of prostate cancer. The positive critical value of serum TPSA quantification is greater than 10μg/L, and the diagnostic specificity of prostate cancer is 90%-97%. TPSA can also be used for screening and early diagnosis of prostate cancer in high-risk populations. It is the first tumor marker recommended by the American Cancer Society for screening prostate cancer in men over 50 years old.

TPSA determination can also be used to monitor the condition and efficacy of prostate cancer patients or patients receiving hormone therapy. The serum TPSA value of 90% of patients after prostate cancer surgery can be reduced to an undetectable trace level. If the serum TPSA value increases after surgery, it indicates residual tumors. For patients with significant efficacy after radiotherapy, more than 50% of patients have their serum TPSA reduced to normal within 2 months.

2. Free prostate-specific antigen (FPSA)

Mainly related tumors: prostate cancer.

Other related tumors: certain gynecological tumors and breast cancer.

Other influencing factors: Prostate hyperplasia can cause an increase.

A single serum total PSA (TPSA) test cannot clearly differentiate between prostate cancer and benign prostatic hyperplasia, mainly because there is overlap between the two groups of patients within the concentration range of 2-20ng/ml. However, FPSA/TPSA is not affected by this factor or age, and the purpose of differentiating between prostate cancer and benign prostatic hyperplasia is achieved through the FPSA/TPSA ratio. The FPSA/TPSA ratio of patients with prostate cancer is significantly lower, while the FPSA/TPSA ratio of patients with benign prostatic hyperplasia is significantly higher. The FPSA/TPSA limit is designated as 0.15, and prostate cancer is highly suspected if it is lower than this value. Its diagnostic sensitivity is 90.9%, specificity is 87.5%, and accuracy is 88.6%, which is significantly better than TPSA alone.

The FPSA test is mainly suitable for untreated patients with a TPSA value of 2-20ng/ml. When the TPSA value is lower than 2ng/ml or higher than 20ng/ml, the FPSA/TPSA ratio cannot be used to differentiate between prostate cancer and benign prostatic hyperplasia.