title: Are total prostate-specific antigen serum levels in cirrhotic men different from those in normal men?
abstract: OBJECTIVE
  To determine the serum total prostate-specific antigen (tPSA) levels in cirrhotic men and compare them with those in noncirrhotic men.
  
  
  METHODS
  We prospectively evaluated 113 cirrhotic patients listed for liver transplantation using the serum tPSA, total testosterone level, and Child-Pugh liver function score according to age and severity of liver disease. The tPSA levels were compared with those of 661 healthy men. The Mann-Whitney U test was used for statistical analysis, with a significance level of .05.
  
  
  RESULTS
  The median age of the cirrhotic and noncirrhotic patients was 55 years (range 28-70) and 58 years (range 46-70), respectively (P < .01). However, when stratified by age group (<49, 50-59, and >60 years), this difference was not significant. The median serum tPSA level was 0.3 ng/mL (range 0.04-9.9) and 1.3 ng/mL (range 0.04-65.8) in the cirrhotic and noncirrhotic group, respectively (P < .0001). Stratifying both groups according to age, the cirrhotic patients had significantly lower tPSA levels than did the noncirrhotic patients. According to the Child-Pugh score (A, B, and C), Child-Pugh class C patients had significantly lower tPSA levels than did Child-Pugh class A patients and also had lower testosterone levels than did Child-Pugh class A and B patients. The tPSA levels correlated significantly with the testosterone levels in the cirrhotic patients (P = .028).
  
  
  CONCLUSIONS
  The results of our study have shown that cirrhotic patients have approximately 4 times lower serum tPSA levels than noncirrhotic men. Patients with more severe liver disease have lower tPSA and testosterone levels than patients less affected. The tPSA levels in cirrhotic men are affected by the total testosterone levels.
authors.affiliation: Department of Urology, Clinics Hospital, University of São Paulo Medical School, São Paulo, Brazil. fabiovicentini@usp.br
authors.forename: Fabio C
authors.initials: FC
authors.lastname: Vicentini
authors.forename: Luiz A A
authors.initials: LA
authors.lastname: Botelho
authors.forename: Marcelo
authors.initials: M
authors.lastname: Hisano
authors.forename: Gustavo X
authors.initials: GX
authors.lastname: Ebaid
authors.forename: Marcos
authors.initials: M
authors.lastname: Lucon
authors.forename: Antonio M
authors.initials: AM
authors.lastname: Lucon
authors.forename: Miguel
authors.initials: M
authors.lastname: Srougi
mesh_terms: D000328:Adult; D000367:Age Factors; D000368:Aged; D014408:Biomarkers, Tumor / Q000097:blood; D016022:Case-Control Studies; D005500:Follow-Up Studies; D006801:Humans; D008103:Liver Cirrhosis / Q000097:blood* / Q000473:pathology / Q000601:surgery; D016031:Liver Transplantation; D008297:Male; D008875:Middle Aged; D011336:Probability; D011446:Prospective Studies; D017430:Prostate-Specific Antigen / Q000097:blood*; D011471:Prostatic Neoplasms / Q000097:blood* / Q000473:pathology / Q000601:surgery; D012016:Reference Values; D012307:Risk Factors; D012680:Sensitivity and Specificity; D012720:Severity of Illness Index; D018709:Statistics, Nonparametric; D013739:Testosterone / Q000097:blood*
chemical_list: D014408:Biomarkers, Tumor; D013739:Testosterone; D017430:Prostate-Specific Antigen