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Year : 2003  |  Volume : 19  |  Issue : 2  |  Page : 120-124

Effect of urinary retention on the levels of prostate specific antigen (PSA) and prostatic acid phosphatase (PAP) in prostatic disease

1 Department of Biochemistry, Christian Medical College, Ludhiana, India
2 Department of Surgery, Christian Medical College, Ludhiana, India

Correspondence Address:
R Chawla
Department of Biochemistry, Christian Medical College & Hospital, Ludhiana - 141 008
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Source of Support: None, Conflict of Interest: None

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In recent years, prostate specific antigen (PSA) has es­tablished itself as the most useful marker for adenocarci­noma of the prostate and has almost replaced the total acid phosphatase and prostatic acid phosphatase (PAP) for screening, diagnosis and monitoring the prostate car­cinoma patients. The PSA levels also rise in benign hyper­plasia of prostate (BPH) but to a lesser extent and high values are usually diagnostic of malignant disease. The present investigation was conducted to study the relevance of PAP estimation with or without PSA in prostatic dis­ease particularly in the context of hospitalized patients with retention of urine. Levels of the 2 markers were esti­mated in 132 patients with prostatic disease and results correlated with histological findings. BPH was detected in 112 patients whereas 20 patients were diagnosed with adenocarcinoma (ADCA) of prostate. Majority of the pa­tients in our study were referred from private clinics and 66.1 % of BPH and 50% of ADCA patients presented with acute urinary retention. Mean PSA and PAP levels in ad­enocarcinoma group were significantly higher (292.7 and 117.35 ng/ml, respectively) than in BPH group (7.05 and 1.92 ng/ml, respectively). It was observed that PSA levels were raised in BPH patients with urinary retention as com­pared to those with no retention. There was, however, no significant change in PAP levels in these patients. There was a very good correlation between the values of tumor markers (correlation coefficient: 0.86) in all the patients. Therefore, PAP is still a very good tumor marker of prostatic disease with almost comparable efficiency to that of PSA in differentiating the malignant from the benign dis­ease. It appears to be particularly important in hospital­ized patients with acute urinary retention as catheterization appears to raise the levels of PSA but not those of PAP.

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