PSA (prostate-specific antigen) is produced primarily by prostate secretion. Many times it is assumed that PSA is only present in men and does not produce PSA in women. So much so that if, during clinical testing, the doctor prescribes a PSA program in the test application form of the female patient, many people will suspect that this is counterintuitive. Either the doctor's clerical error or the patient's gender was not noticed and an application for testing was made.
So for the female PSA test that is "accidentally" encountered in the test, and the test result value is not low (because there is no female PSA reference value, it can only be measured by the male reference value), how to explain it?
Case after
On duty, a resident doctor appeared in the office with a test report, and specifically indicated that the sex of the patient in the swelling report was female, and the PSA detection value was: 0.29 ng/mL (there is no female PSA reference value, only the male reference value: 0--4.0 ng/mL can be measured). He questioned whether the specimen had testing problems, whether such conditions were encountered, and whether there were other conditions that would lead to high test results for serum PSA in women.
Combined with the questions he asked, I answered them one by one. First of all, after the system review and the confirmation of the specimen of the day, the problem of specimen collection and dosing errors was ruled out. Secondly, the affirmative answer was that we had encountered such situations. Finally, he was exchanged about the value of the next PSA in the current serum test. In particular, some diseases that may cause elevated serum PSA in women have been discussed, and are now summarized and encouraged by Jun.
Case studies
1. Generation of PSA:
The conventional wisdom is that PSA can only be secreted by the prostate, but recently a growing body of research has found that PSA, although called a prostate-specific antigen, is not specific to the prostate. PSA can also be secreted by many female organs, including the breasts, the Skean glands, the salivary glands (parotid glands, sublingual glands, and submandibular glands), and some tumor tissues (breast, lung, ovarian, etc.).
2. Diseases that cause high serum PSA in women:
PSA is important in the diagnosis of prostate cancer, and PSA can also be detected in some other diseases, particularly in some female-specific diseases, along with studies of PSA. For example, tumor tissue (breast cancer, lung cancer, ovarian cancer, etc.) can secrete PSA, female polycystic ovary syndrome (PCOS), female hirsutism, fibroadenoma, breast cysts, when taking male hormones, serum PSA concentration will increase significantly (some increases can reach more than a thousand times), which shows that PSA is not just a "privilege" for men.
3. Concentration and measurement of PSA in women's bodies:
Because the PSA concentration in normal men is below 4ng/mL, and the PSA concentration in normal women can be 1000 times different from that of normal men, that is to say, the PSA concentration in normal women is at the level of pg/mL, and it is difficult for traditional measurement methods to achieve such sensitivity. However, in recent years, there have been commercialized hypersensitive PSA kits that can determine PSA concentrations in the low concentration range, and the determination sensitivity can reach the fg level, making it possible to determine PSA with near-zero concentrations.
4. Significance of PSA detection in women:
Although the content of PSA in the female body under normal conditions is negligible, the PSA concentration in some pathological conditions will rise significantly, thus making it possible to diagnose and monitor certain diseases in women through changes in PSA concentrations, and the following table shows the changes in PSA in women in certain disease states:
From this point of view, with the support of science and technology, the detection of PSA in women's bodies will gradually emerge in the near future, and a new chapter will be opened in the process of diagnosing and judging the prognosis of related diseases. However, as an examiner, you should update your knowledge reserves in time and pay more attention to frontier disciplines and research. In this way, we can better play our inspection tool in our work!
【Reference】
[1]. Prostate-Specific Antigen as a Marker of Hyperandrogenism in Women and Its Implications for Antidoping.
[2]. Zaviacic M, Ablin RJ. The female prostate. J Natl Cancer Inst. 1998,90(9):713-714.
Source: Inspection Horizon Network
Editor: Ren Mileage Reviewer: Xiao Ran
