title: Prostate-specific antigen levels and density in the internal and external glands of the prostate in benign prostatic hyperplasia patients with normal or gray-zone PSA levels.
abstract: OBJECTIVE
  In patients with benign prostatic hyperplasia (BPH) showing normal prostate-specific antigen (PSA) levels (normal PSA group) and those with BPH showing gray-zone PSA levels (gray-zone PSA group), we assessed PSA levels secreted from the internal and external glands.
  
  
  METHODS
  We performed transurethral enucleation of the prostate (TUE) in 102 BPH patients with normal PSA and 59 BPH patients with gray-zone PSA at our department from 1999 to 2001. Preoperatively and approximately 6 months postoperatively, we measured serum PSA levels and determined prostatic volumes via transrectal ultrasonography (TRUS) to calculate PSA levels secreted from the internal and external glands as well as various PSA density (PSAD) values.
  
  
  RESULTS
  The total PSA level was 1.8 and 6.1 ng/ml in the normal and gray-zone PSA groups, respectively. The PSA level of the external gland was 0.6 and 0.8 ng/ml and the PSAD of the external gland was 0.07 and 0.08 ng/ml/cm(3) in the normal and gray-zone PSA groups, respectively. The internal gland PSA was 1.3 and 5.4 ng/ml and the internal gland PSAD value was 0.11 and 0.30 ng/ml/cm(3) in the normal and gray-zone PSA groups, respectively.
  
  
  CONCLUSIONS
  Our results demonstrated that increased PSA levels in BPH cases with gray-zone PSA were attributable to increased PSA secreted from the internal gland rather than from the external gland. In our opinion, the determination of PSA and PSAD of the internal and external gland may be clinically significant in the future.
authors.affiliation: Department of Urology, Tama-Nagayama Hospital, Nippon Medical School, Tokyo, Japan.
authors.forename: Wei
authors.initials: W
authors.lastname: Zuo
authors.forename: Yasunori
authors.initials: Y
authors.lastname: Hiraoka
mesh_terms: D000368:Aged; D016022:Case-Control Studies; D006801:Humans; D008297:Male; D011467:Prostate / Q000000981:diagnostic imaging / Q000473:pathology*; D017430:Prostate-Specific Antigen / Q000032:analysis / Q000097:blood*; D011470:Prostatic Hyperplasia / Q000000981:diagnostic imaging / Q000473:pathology* / Q000601:surgery; D020728:Transurethral Resection of Prostate; D014463:Ultrasonography
chemical_list: D017430:Prostate-Specific Antigen