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

Eur Urol. 1999 Nov;36(5):409-12. doi: 10.1159/000020022.


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.

Publication types

  • Clinical Trial
  • Controlled Clinical Trial

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Humans
  • Liver Cirrhosis / physiopathology*
  • Liver Function Tests
  • Male
  • Middle Aged
  • Prostate-Specific Antigen / blood*
  • Reference Values
  • Risk Assessment
  • Sensitivity and Specificity


  • Prostate-Specific Antigen