What is the cause of high total prostate specific antigen?

If you find that your total prostate-specific antigen is high after a physical examination, you will be very nervous. This test result cannot determine whether you have a prostate-related disease. You should still do a more comprehensive examination, especially a prostate fluid examination. This can be said to be a method of examination that can draw more accurate conclusions and avoid misdiagnosis during the examination.

Prostate specific antigen (PSA) is a single-chain glycoprotein with 237 amino acid residues produced by the intracellular plasma vesicles of prostate epithelial cells. Its molecular weight is about 34kD and it is a serine protease that belongs to the class of kallikrein in function. PSA exists in the prostate endoplasmic reticulum, prostate epithelial cells and secretions. Both normal and diseased prostate tissues contain PSA, and the PSA content of a single cell is relatively constant. PSA can be inactivated by binding to α1-antichymotrypsin and α2-macroglobulin. Usually, there is no or only a very small amount of PSA in the blood.

Abnormal results

(1) The serum free PSA (F-PSA) and total PSA (T-PSA) values ​​of prostate cancer patients are significantly increased, with the increase of T-PSA being more obvious, so the ratio of free PSA to total PSA (F/T ratio) decreases. The F/T ratio can be used to distinguish prostate cancer from prostate hyperplasia. Especially when the PSA level is limited to the range of 4-10μg/L, the F/T ratio is better than PSA.

(2) PSA has important clinical significance for the early diagnosis, clinical staging, postoperative efficacy observation and follow-up of prostate cancer.

(3) Prostatic hyperplasia (BPH), prostatic infarction, acute bacterial prostatitis, acute urinary tract obstruction, etc. can also cause an increase in serum PSA levels.

People who need to be checked include those who have symptoms such as frequent urination, urgency, urinary retention, urinary pain, difficulty forming a urine stream, hematuria, and bone pain.

Possible diseases if the result is high:

Seminal vesicle malignancy, prostate cancer, bladder adenocarcinoma

Before the test:

1. Do not eat greasy or high-protein food and avoid drinking a lot of alcohol the day before blood collection. The alcohol content in the blood will directly affect the test results.

2. You should fast for 12 hours after 8 pm the day before the physical examination to avoid affecting the test results.

3. Relax when drawing blood to avoid contraction of blood vessels due to fear, which will increase the difficulty of blood collection.

After inspection:

1. After drawing blood, apply local pressure on the needle hole for 3-5 minutes to stop bleeding. Note: Do not rub to avoid subcutaneous hematoma.

2. The pressing time should be sufficient. The coagulation time of each person is different. Some people need a little longer time to coagulate. Therefore, if you stop pressing immediately when the skin surface seems to have stopped bleeding, the blood may not stop completely, and the blood may seep into the subcutaneous layer and cause bruises. Therefore, pressing for a longer time can completely stop the bleeding. If there is a tendency to bleed, the pressing time should be extended.

3. If you experience symptoms of needle sickness after blood drawing, such as dizziness, blurred vision, fatigue, etc., you should lie down immediately and drink a small amount of sugar water. Wait until the symptoms are relieved before having a physical examination.