Open Access

ARTICLE

Urinary prostate-specific antigen: predictor of benign prostatic hyperplasia progression?

Tomislav P. Pejcic¹, Cane Dz. Tulic^1,2, Natasa V. Lalic³, Biljana D. Glisic³, Svetlana D. Ignjatovic^3,4, Biljana B. Markovic^2,5, Jovan B. Hadzi-Djokic⁶

1 Clinical Center of Serbia, Urological Clinic, Belgrade, Serbia
2 Belgrade University, School of Medicine, Belgrade, Serbia
3 Clinical Center of Serbia, Center for Medical Biochemistry, Belgrade, Serbia
4 Department of Biochemistry, University of Belgrade, School of Pharmacy, Belgrade, Serbia
5 Clinical Center of Serbia, Institute for Radiology, Belgrade, Serbia
6 Serbian Academy of Sciences and Arts, Belgrade, Serbia
Address correspondence to Dr. Tomislav P. Pejcic, Bulevar Zorana Djindjica 129/9, 11070 Belgrade, Serbia

Canadian Journal of Urology 2013, 20(2), 6707-6713.

Abstract

Introduction: Urinary prostate-specific antigen (uPSA) can be used as an additional parameter of benign prostatic hyperplasia (BPH) progression.
Materials and methods: From January 2001 to December 2011, uPSA was determined in 265 patients with benign prostate. Based on total prostate volume (TPV), the patients with benign prostate were divided into two groups: TPV < 31 mL and TPV ≥ 31 mL. Additionally, three groups were formed according to MTOPS study criteria: non-progressive BPH group (TPV < 31 mL, PSA < 1.6 ng/mL, age < 62 yrs), intermediate group (one or two parameters {TPV, PSA, age} increased), and progressive BPH group (TPV ≥ 31 mL, PSA ≥ 1.6 ng/mL, age ≥ 62 yrs).
Results: Average uPSA values in the groups TPV < 31 mL and TPV ≥ 31 mL were 119.3 ± 124.5 and 255.5 ± 204.9 ng/mL, respectively, and they were significantly different (p < 0.0001). Average uPSA values in the non-progressive BPH group, intermediate group, and progressive BPH group were 86.8 ± 82.4 ng/mL, 166.6 ± 164.9 ng/mL, and 274.9 ± 208.3 ng/mL, respectively, and they were significantly different (p < 0.0001). The level of uPSA correlated significantly with TPV (r = 0.32, p < 0.0001). The cut-off uPSA level of 150 ng/mL discriminates patients with non-progressive BPH and progressive BPH with a specificity of 0.83 and sensitivity of 0.67.
Conclusion: The level of uPSA reflects prostatic hormonal activity and correlates with TPV, PSA, and age. A uPSA level ≥ 150 ng/mL can be used as an additional predictive parameter of BPH progression.

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