Acta Scientific Medical Sciences (ASMS)(ISSN: 2582-0931)

Research Article Volume 7 Issue 1

Serum Prostate-Specific Antigen (PSA) Level is a Biomarker for Prostate Adenocarcinoma Grade, Tumour Volume and Histologic Prognostic Indicators

Grace Ferguson1, Luke Gilligan1, Caitlyn Keogh1 and Paul H Hartel2-4*

1Department of Forensic Investigation and Analysis, Atlantic Technological University, Ireland
2Sligo University Hospital, Department of Pathology, Ireland
3National University of Ireland, Galway School of Medicine, Department of Pathology, Ireland
4West Virginia University School of Medicine, Department of Medicine, USA

*Corresponding Author: Paul H Hartel, Sligo University Hospital, Department of Pathology, Ireland.

Received: December 09, 2022; Published: December 19, 2022


While serum PSA has limited specificity for prostate cancer detection, and its appropriate clinical application remains a topic of debate, it has been shown to correlate with cancer grade and some measures of tumour volume. We sought to replicate these findings and also establish the utility of PSA as a potential biomarker for prognostic indicators in patients with needle biopsies positive for prostate adenocarcinoma. Following clinical audit CoPath electronic archive search using keywords ‘prostate’ and ‘adenocarcinoma,’ anonymized reports from 43 clinical audit needle biopsies positive for prostate adenocarcinoma from 2015 through 2022 were reviewed. Data on primary and secondary tumour grade, histologic Gleason score, Grade group, tumour volume, perineural invasion and extraprostatic extension were reviewed with associated PSA levels. Patients with cancers that fell into Grade groups 1 and 2 (Gleason 3+3 and 3+4), had an average PSA level of 10.55 ng/ml, while those in higher Grade groups 3, 4 and 5 (Gleason 4+3, 4+4, 4+5, 5+4 and 5+5), had an average PSA of 26.09 ng/ml. Patients with higher tumour volume (> = 60% of biopsy tissue containing tumour) had an average PSA level of 22.98 ng/ml, while patients with lower tumour volume (<or = 40% of biopsy tissue containing tumour) had an average PSA level of 8.60 ng/ml. In patients with perineural invasion their average PSA level was 16.34 ng/ml, while those without had an average of 12.30 ng/ml. Similarly, patients with extraprostatic extension had an average PSA of 20.50 ng/ml, while those without had an average of 12.90 ng/ml.

Keywords: Prostate Cancer; Tumor Volume; Grade Groups; Perineural Invasion; Extraprostatic Extension


  1. Hsing A., et al. “International trends and patterns of prostate cancer incidence and mortality”. International Journal of Cancer 85 (2000): 60-67.
  2. Wang MC., et al. “Purification of a human prostate specific antigen”. Investigative Urology 2 (1979): 159-163.
  3. Stamey TA., et al. “Prostate-specific antigen as a serum marker for adenocarcinoma of the prostate”. The New England Journal of Medicine 15 (1987): 909-916.
  4. Wang TY., et al. “Preliminary evaluation of measurement of serum prostate-specific antigen level in detection of prostate cancer”. Annals of Clinical and Laboratory Science 6 (1986): 461-466.
  5. Kuriyama M., et al. “Use of human prostate-specific antigen in monitoring prostate cancer”. Cancer Research 41 (1981): 3874-3876.
  6. Catalona WJ., et al. “Measurement of prostate-specific antigen in serum as a screening test for prostate cancer”. The New England Journal of Medicine17 (1991): 1156-1161. 
  7. Cooner WH., et al. “Prostate cancer detection in a clinical urological practice by ultrasonography, digital rectal examination and prostate specific antigen”. The Journal of Urology6 (1990): 1146-1152. 
  8. Merriel SWD., et al. “Prostate Cancer in Primary Care”. Advances in Therapy9 (2018): 1285-1294. 
  9. Grossman DC., et al. “Screening for prostate cancer: US Preventive services task force recommendation statement”. JAMA 18 (2018): 1901-1913.
  10. Carlsson SV., et al. “Screening for Prostate Cancer”. Medical Clinics of North America 6 (2020): 1051-1062.
  11. Martin RM., et al. ”Effect of a low-intensity PSA-based screening intervention on prostate cancer mortality: the CAP randomized clinical trial”. JAMA9 (2018): 883-895.
  12. Pinsky PF., et al. “Extended mortality results for prostate cancer screening in the PLCO trial with median follow-up of 15 years”. Cancer 4 (2017): 592-599.
  13. Schröder FH., et al. “Screening and prostate cancer mortality: results of the European Randomised Study of Screening for Prostate Cancer (ERSPC) at 13 years of follow-up”. Lancet9959 (2014): 2027-2035.
  14. Ilic D, et al. “Prostate cancer screening with prostate-specific antigen (PSA) test: a systematic review and meta-analysis”. BMJ362 (2018): k3519.
  15. Omri N., et al. “Association between PSA density and pathologically significant prostate cancer: The impact of prostate volume”. Prostate16 (2020): 1444-1449.
  16. Matsugasumi T., et al. “Impact of prostate-specific antigen screening on tumor size in patients with prostate cancer in a super-aging district in Kyoto, Japan”. International Journal of Clinical Oncology 12 (2021): 2303-2309.
  17. Kollmeier MA., et al. “Salvage brachytherapy for recurrent prostate cancer after definitive radiation therapy: A comparison of low-dose-rate and high-dose-rate brachytherapy and the importance of prostate-specific antigen doubling time”. Brachytherapy6 (2017): 1091-1098.
  18. Van Poppel H., et al. “Serum PSA-based early detection of prostate cancer in Europe and globally: past, present and future”. Nature Reviews Urology9 (2022): 562-572.


Citation: Paul H Hartel., et al. “Serum Prostate-Specific Antigen (PSA) Level is a Biomarker for Prostate Adenocarcinoma Grade, Tumour Volume and Histologic Prognostic Indicators”.Acta Scientific Medical Sciences 7.1 (2023): 60-63.


Copyright: © 2022 Paul H Hartel., et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.


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