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Clinical Chemistry 45: 814-821, 1999;
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(Clinical Chemistry. 1999;45:814-821.)
© 1999 American Association for Clinical Chemistry, Inc.

Articles

Measurement of the Complex between Prostate-specific Antigen and {alpha}1-Protease Inhibitor in Serum

Wan-Ming Zhang1, Patrik Finne1, Jari Leinonen1, Satu Vesalainen2, Stig Nordling3 and Ulf-HÅkan Stenman1,a

Departments of
1 Clinical Chemistry,
2 Urology, and
3 Pathology, Helsinki University Central Hospital, FIN-00290 Helsinki, Finland.
a Author for correspondence. Fax 00358-09-4714804; e-mail ulf-hakan.stenman{at}huch.fi

Background: Prostate-specific antigen (PSA) occurs in serum both free and in complex with protease inhibitors. The complex with {alpha}1-antichymotrypsin (ACT) is the major form in serum, and the proportion of PSA-ACT is higher in prostate cancer (PCa) than in benign prostatic hyperplasia (BPH). PSA also forms a complex with {alpha}1-protease inhibitor (API) in vitro, and the PSA-ACT complex has been detected in serum from patients with prostate cancer. The aim of the present study was to develop a quantitative method for the determination of PSA-API and to determine the serum concentrations in patients with PCa and BPH.

Methods: The assay for PSA-API utilizes a monoclonal antibody to PSA as capture and a polyclonal antibody to API labeled with a Eu-chelate as a tracer. For calibrators, PSA-API formed in vitro was used. Serum samples were obtained before treatment from 82 patients with PCa, from 66 patients with BPH, and from 22 healthy females.

Results: The concentrations of PSA-API are proportional to the concentrations of total PSA. PSA-API comprises 1.0–7.9% (median, 2.4%) of total immunoreactive PSA in PCa and 1.3–12.2% (median, 3.6%) in BPH patients with serum PSA concentrations >4 µg/L. In patients with 4–20 µg/L total PSA, the proportion of PSA-API serum is significantly higher in BPH (median, 4.1%) than in PCa (median, 3.2%; P = 0.02).

Conclusions: The proportion of PSA-API in serum is lower in patients with PCa than in those with BPH. These results suggest that PSA-API is a potential adjunct to total and free PSA in the diagnosis of prostate cancer.© 1999 American Association for Clinical Chemistry




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