Serum free and total prostate-specific antigen levels in patients with liver disease

Objectives. To determine the effect of liver diseases on serum free prostate-specific antigen (fPSA) levels, total prostate-specific antigen (tPSA) levels, and fPSA/tPSA ratios. Methods. Serum concentrations of tPSA and fPSA were measured in 18 men with histologically confirmed liver cirrhosis, 20 men with histologically proved chronic hepatitis, and 20 healthy men. All patients underwent a standard urologic evaluation, including history, physical examination, urine analysis, serum fPSA and tPSA determinations, and liver function tests (serum bilirubin, serum glutamic oxaloacetic transaminase, and serum glutamic pyruvic transaminase). Results. Patients with liver cirrhosis had slightly lower fPSA levels than did control subjects or patients with chronic hepatitis, but these differences did not reach statistical significance. tPSA levels also were not significantly different among the three groups. Conclusions. In the presence of liver disease, despite the limited liver reserve, tPSA and fPSA are specific and reliable markers in the clinical management of prostatic diseases in this population. This result should be taken into account when serum concentrations of fPSA, tPSA, and the fPSA/tPSA ratio are evaluated in patients with liver disease. (C) 1998, Elsevier Science Inc. All rights reserved.