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Prostate Specific Antigen in Non-Serum Samples from Women

Since Wang et al (1) purified PSA, it has been the most important tumor marker in patients with prostate cancer. PSA was originally described as a prostate specific antigen. However, Yu and Diamandis have demonstrated recently that PSA is produced also by tissues other than the prostate (2-4). These data necessitate reevaluation of the tissue specificity of PSA. To do this we studied the presence of PSA in 80 non-serum samples from women. The samples comprised 15 lacteal secretions from 10 non-lactating women without any clinical disease and from 5 lactating women; 20 amniotic fluids; 10 bronchoalveolar lavage fluids from patients with pneumonia; 25 breast cyst fluids; 5 ovarian cyst fluids and 5 ascitic fluids from patients with hepatic cirrhosis. PSA was measured by an ultrasensitive automatized immunoassay in a Cobas Core analyzer (Roche Diagnostic Systems, Basel, Switzerland) with an analytical sensitivity of 0.04Ilg/L. PSA levels were undetectable in all ovarian cyst and ascitic fluids. In contrast, the presence of PSA was detected in most of the breast secretions (100%), amniotic fluids (100%), bronchoalveolar fluids (60%) and breast cysts (84%). Furthermore, PSA levels greater than 1 ug/l, were observed in 18 of these samples, the levels being extremely high and even exceeding 100 ug/L in four breast secretions (Fig. 1). To exclude the possibility of PSA detection being due to a matrix effect, we performed serial dilutions of a sample with a PSA level of 27 ug/L and obtained a recovery range between 96% and 109%. Yu and Diaman-