Prostate test

Benefits of Prostate test from blood

• Recommended for men with a positive family history of prostate cancer
• Determining the health status of the prostate
• Results within 3 days
• Combination of PSA and PHI testing
  

What´s measured

What is PSA, or prostate specific antigen?

PSA, prostate-specific antigen, is a proteolytic enzyme produced by the epithelial cells lining the ducts of the prostate glands. Its role is to liquefy the ejaculate. A small fraction of PSA is secreted into the bloodstream, where it circulates in the free (10%) or bound form to A1AT (86% of total PSA) and A2MG. It is also present in the perinanal and paraurethral glands, in the bladder and in the mammary gland. It is only released into the bloodstream to an increased extent when the microstructure of the prostate tissue is disturbed, i.e. in various inflammations or tumours.

An important role of PSA is the liquefaction of the ejaculate. The elimination half-life is 1-3 days, in one day 50-80% of the original amount remains. Although screening of asymptomatic men is questionable because up to 80% of men with a total PSA above 4 mg/L do not have prostate cancer, the degree of elevated PSA concentration correlates with the size and condition of the tumor.

What is the PHI, or healthy prostate index?

The PHI (Healthy Prostate Index) is a derived mathematical algorithm that represents another modern method for detecting prostate cancer, especially in men aged 50 to 65 years with a total PSA level between 2.0 and 10.0 ug/l. The comprehensive prostate test includes the determination of PSA (prostate specific antigen), fPSA (free PSA - the free fraction of circulating PSA), fPSA/tPSA index (ratio of free PSA to total PSA), p2PSA (precursor form of free PSA).

It is released into the bloodstream at an increased rate only when the microstructure of the prostate tissue is disrupted. It is synthesised as an enzymatically inactive precursor, with the most clinically relevant form of free PSA being the precursor molecule p2PSA, which is used in diagnostics because it is more specific for prostate cancer. A small fraction of PSA circulates in the bloodstream in the free form, the larger fraction in the bound form. The free fraction of circulating PSA, fPSA, is an organ-specific marker. The absolute value of fPSA is not important for diagnosis, but the ratio to total PSA. The screening of asymptomatic (asymptomatic) men is a matter of professional debate because up to 80% of men with a total PSA above 4 ug/l are not diagnosed with prostate cancer, but only with benign prostatic hyperplasia (BPH). Nevertheless, in the case of carcinoma, the degree of increase in PSA concentration may correlate with the size and condition of the tumour.

Prostate screening is recommended for a positive family history of prostate cancer, suspected prostate disease, a mildly enlarged prostate, low to moderately elevated PSA levels, and is appropriate for men aged 50 to 65 years with a total PSA level between 2.0 and 10.0 ug/L.

During the prostate test, we also measure the levels of the following parameters
In addition to the PHI (Healthy Prostate Index) and PSA (Prostate Specific Antigen) tests mentioned above, we also measure the level of: 

fPSA

The fPSA test is recommended to differentiate prostate cancer from benign prostatic hyperplasia (BPH) at low to slightly elevated PSA levels. Men with prostate cancer with a normal or only slightly enlarged prostate have a lower percentage of free PSA than patients with BPH.

p2PSA

p2PSA is a proenzyme of prostate-specific antigen, a fraction of free PSA that circulates in the plasma. It enters the bloodstream and its quantity can be used to assess not only the presence of a tumor but also the risk of developing one. Since increased PSA production also exists in benign prostate disease, especially in common benign prostatic hyperplasia, a diagnosis based on PSA testing alone is not conclusive, and p2PSA refines the clinical significance of the determination.
To calculate the PHI (healthy prostate index), PSA, fPSA and p2PSA should be determined. If the PSA value is outside the range of 2 to 10 ug/l, the PHI cannot be calculated.

When to have Prostate test (PSA+PHI)

• During a preventive checkup
• With a positive family history of prostate cancer
• When prostate cancer is suspected
• For prostate cancer to determine clinical stage and prognosis
• To monitor treatment and possibly detect recurrence

Interpretation of results

It is important to stress that if you have an elevated or decreased PSA level, you should always contact your urologist or general practitioner and consult the results with your GP. If you have made an appointment for this test yourself and it has not been recommended by your doctor, please be aware that the decision to have this test is your responsibility and Unilabs cannot give you specific advice on whether it is suitable for you.