Serum levels of free and total prostate-specific antigen in males with liver cirrhosis

Objectives: We examined the serum concentrations of total and free prostate-specific antigen (PSA) from patients with liver cirrhosis to clarify the influence of liver function on serum PSA levels. Methods: Serum concentrations of total and free PSA, as well as the free/total PSA ratio were measured in 75 male patients with histologically confirmed liver cirrhosis. As a control group, 75 age-matched healthy blood donors were studied. Results: The serum levels of total PSA in liver cirrhosis patients were significantly lower than those in controls (p = 0.0004). However, the serum free/total PSA ratios in liver cirrhosis patients were significantly higher than those of controls (p < 0.0001). Conclusions: Our results suggest the absence of an obvious clearance disturbance of serum PSA as a result of severe hepatic dysfunction and offer caution against the utility of standard cutoff values of serum PSA or free/total PSA ratios in the detection and staging of prostate cancer in men with severe liver dysfunction.