title: Between-subject variations of transition zone epithelial volume and serum PSA levels in men with benign prostatic hyperplasia.
abstract: OBJECTIVE
  We verified if the measure of transition zone epithelial volume (TZepiV) could be a valid predictor of serum PSA value in men with benign prostatic hyperplasia (BPH).
  
  
  METHODS
  Between January 2005 and July 2008, a total of 90 patients undergoing transvesical suprapubic adenomectomy for sintomatic BPH were enrolled. In case of an elevated PSA level (above 4 ng/ml) or abnormal digital rectal examination, systematic multisite biopsies were performed preoperatively to rule out prostate cancer. We have examined PSA levels before and after open surgery, TZ weight as measured by the pathologist and TZepiV by multiplying percentage of epithelium of a single biopsy core with the weight of adenoma. Means, Spearman correlation coefficients and percent change were calculated for all variables and intervals.
  
  
  RESULTS
  The mean serum PSA decreased from 4.8 ng/ml preoperatively to 0.5 ng/ml postoperatively. The mean decrease in PSA was 90% (range 70-99%).The mean weight of enucleated adenoma was 67 gr.(range 18-201) and the TZepiV was 7.7 ml (0.3-28.4). Overall, both TZ volume and TZepiV were correlated to PSA value with TZepiV representing the most predictive variable for PSA (r = 0.54 P = 0.002 vs. r = 0.26 P = 0.02). When we analyzed different ranges of PSA values, only TZepiV was always significantly proportional to PSA.
  
  
  CONCLUSIONS
  Ninety percentage of serum PSA level comes from TZ in range of 0.01-0.17 ng/ml/gr. In presence of equal BPH volumes, the amount of epithelium can be different and it is the main determinant in PSA increase. Thus, TZ epithelial volume could represent a new useful clinical tool able to increase the specificity of PSA in the diagnosis of prostate cancer.
authors.affiliation: Division of Urology, G Mazzini Hospital, Teramo, Italy. oreste.martella@virgilio.it
authors.forename: Martella
authors.initials: M
authors.lastname: Oreste
authors.forename: Paradiso Galatioto
authors.initials: PG
authors.lastname: Giuseppe
authors.forename: Pace
authors.initials: P
authors.lastname: Gianna
authors.forename: Angelucci
authors.initials: A
authors.lastname: Adriano
authors.forename: Necozione
authors.initials: N
authors.lastname: Stefano
authors.forename: Bologna
authors.initials: B
authors.lastname: Mauro
authors.forename: Vicentini
authors.initials: V
authors.lastname: Carlo
mesh_terms: D000236:Adenoma / Q000097:blood* / Q000473:pathology* / Q000601:surgery; D000368:Aged; D000369:Aged, 80 and over; D000704:Analysis of Variance; D001707:Biopsy, Needle; D015331:Cohort Studies; D004848:Epithelium / Q000473:pathology*; D005500:Follow-Up Studies; D006801:Humans; D007150:Immunohistochemistry; D008297:Male; D008875:Middle Aged; D011336:Probability; D017430:Prostate-Specific Antigen / Q000097:blood*; D011468:Prostatectomy / Q000379:methods; D011470:Prostatic Hyperplasia / Q000097:blood* / Q000473:pathology* / Q000601:surgery; D012189:Retrospective Studies; D018570:Risk Assessment; D020728:Transurethral Resection of Prostate / Q000379:methods; D016896:Treatment Outcome; D047368:Tumor Burden
chemical_list: D017430:Prostate-Specific Antigen
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