Chemistry and Biochemistry: Research Progress Vol. 10

Background: Prostate-specific antigen (PSA) is a widely used screening biomarker for prostate diseases. Although organ‑specific, it lacks disease specificity; elevated serum PSA levels are observed not only in prostate cancer (PCa) but also in benign prostatic hyperplasia (BPH), prostatitis, urinary tract infection (UTI), and after prostatic interventions. This diagnostic overlap often leads to unnecessary biopsies and patient anxiety, underscoring the need for comparative evaluation of PSA across these conditions.

Aim: The study aims to evaluate and compare serum PSA levels in patients with BPH, BPH complicated by UTI, and prostatic carcinoma.

Methods: This hospital‑based cross‑sectional study included 300 male patients aged >50 years presenting with lower urinary tract symptoms. Participants were categorised into four groups: BPH (n=162), prostatic carcinoma (n=50), BPH+UTI (n=63), and healthy controls (n=25). Serum PSA was estimated by sandwich ELISA. Data were analysed using ANOVA and Pearson’s correlation.

Results: BPH was the most common diagnosis (54%). In the BPH and prostatic carcinoma groups, PSA levels showed no significant age‑related variation (p=0.445 and p=0.129, respectively). However, a significant association between age and PSA was observed in the BPH+UTI group (p=0.050), with the highest mean PSA (13.81 ng/mL) in patients aged >90 years. No significant correlation was found between International Prostate Symptom Score (IPSS) and PSA in BPH patients (p=0.129).

Conclusion: PSA elevation reflects underlying prostate pathology rather than age alone, with infectious and inflammatory conditions contributing substantially to increased levels. The lack of disease specificity necessitates cautious interpretation of PSA results alongside clinical findings, digital rectal examination, and histopathological evaluation to avoid misdiagnosis and overtreatment.