Extraprostatic production of prostate specific antigen is under hormonal control.
OBJECTIVE
Prostate specific antigen (PSA) is the most useful tumor marker in urology. It is produced primarily by the epithelial cells of the ducts and acini of the prostate gland. Extraprostatic production of PSA is provided mainly by the periurethral glands, leading to measurable urine but undetectable serum levels of PSA in women and in men following radical prostatectomy for pathologically localized disease.


METHODS
We investigated the effect of continuous testosterone substitution (250 mg. every 4 weeks) on urinary PSA excretion in 20 patients who converted from the female to male gender. We compared the results to urine levels in 20 women who did not receive testosterone.


RESULTS
Mean urinary PSA plus or minus standard deviation was 1.73 +/- 1.68 ng./ml. in controls and 12.03 +/- 10.47 ng./ml. in converted patients, a statistically significant difference (p < 0.0001). Serum PSA did not differ between groups.


CONCLUSIONS
Our data demonstrate that extraprostatic PSA production is under androgen control.
Breul
J
J
Department of Urology, Technische Universität München, Klinikum rechts der Isar, Germany.
Pickl
U
U
Schaff
J
J
D000328:Adult; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D017430:Prostate-Specific Antigen / Q000096:biosynthesis* / Q000378:metabolism; D013739:Testosterone / Q000502:physiology*; D014521:Urethra / Q000378:metabolism
D013739:Testosterone; D017430:Prostate-Specific Antigen