title: The investigation of total PSA, free PSA, and free/total PSA ratio in patients with liver cirrhosis patients according to Child-Pugh score.
abstract: OBJECTIVE
  To investigate the total prostate-specific antigen (tPSA), free PSA (fPSA), and free/total PSA (fPSA/tPSA) ratio in patients with liver cirrhosis (LC) according to the severity of hepatic insufficiency.
  
  
  METHODS
  Eighty-two male patients with LC were studied. The severity of liver disease was categorized by Child-Pugh score (Child-Pugh A, B, and C). Forty-two age-matched healthy subjects were used as a control group. The tPSA, fPSA, fPSA/tPSA ratio, total prostate volume (TPV), total testosterone (TT), and total protein (TP) were measured. The LC group was compared with the control group in terms of these parameters. In addition, intra-comparison and inter-comparison was made between all the Child-Pugh groups and normal subjects, in terms of these parameters.
  
  
  RESULTS
  The tPSA and fPSA levels in LC cases, Child-Pugh A, Child-Pugh B, and Child-Pugh C groups were significantly decreased compared with the control group. The ratio of fPSA/tPSA in the LC subjects and Child-Pugh A groups significantly increased compared with the control group. TT, TP levels, and TPV in patients with LC were significantly lower compared with the control group and the results were significantly correlated with the Child-Pugh score.
  
  
  CONCLUSIONS
  The present study reveals that tPSA and fPSA were decreased in patients with LC in comparison to healthy subjects in terms of 3 mechanisms. First, it might be due to shrunken prostatic volume. Second, it also resulted in decreased levels of testosterone because of the abnormality of hypothalamic-pituitary-testicular axis. Third, it might be the diminished serum protein level in the composition of the PSA.
authors: Department of Urology, Mustafa Kemal University School of Medicine, Antakya, Turkey. mehmetinci@gmail.com
authors: Mehmet
authors: M
authors: Inci
authors: Murat Mehmet
authors: MM
authors: Rifaioglu
authors: Melek
authors: M
authors: Inci
authors: Murat
authors: M
authors: Celik
authors: Mehmet
authors: M
authors: Demir
authors: Turker
authors: T
authors: Ulutas
authors: Mursel
authors: M
authors: Davarci
authors: Vicdan Koksaldi
authors: VK
authors: Motor
authors: Ramazan
authors: R
authors: Davran
authors: Cumali
authors: C
authors: Gokce
mesh_terms: D006801:Humans; D008103:Liver Cirrhosis / Q000097:blood*; D008297:Male; D008875:Middle Aged; D017430:Prostate-Specific Antigen / Q000097:blood*; D012720:Severity of Illness Index
chemical_list: D017430:Prostate-Specific Antigen