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PSA

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Diğer Adları: Total PSA; Serbest PSA; Kompleks PSA
Resmi adı: Prostat Spesifik Antijen

Bir Bakışta

Niçin Testi Yaptıracaksınız?

Prostat kanseri açısından  hastalık belirtisi veren  semptomatik ve vermeyen  asemptomatik erkekleri taramak, prostat  biyopsisi gerekliliğini ve  prostat kanseri tedavisinin etkinliğini belirlemeye yardımcı olmak ve prostat kanseri nüksünü saptamak için bu test yapılır. Prostat kanseri taraması için PSA testlerini kullanma konusunda halen bir uzlaşı bulunmamaktadır.

Ne Zaman Testi Yaptıracaksınız?

Erkeklerde zor, ağrılı  ve/veya sık sık işeme gibi prostat kanserini düşündüren belirtiler varlığında prostat kanseri tedavisi sırasında ve sonrada düzenli aralıklarla bu test istenebilir. Hastalık belirtileri olmayan erkeklerde tarama testi olarak ne zaman ve ne sıklıkla PSA testi istendiği konusunda uzmanlar ve ulusal kuruluşlar sürekli tartışma halindedir.  Prostat kanseri tarama testlerinin uygulanma sıklığı doktorunuzla tartışma sonucu belirlenmesi gereken bireysel bir karardır. (Spesifik ayrıntılar için bkz.  50 yaş ve üstü erişkinler için prostat kanseri  taraması ).

Gerekli Numune Nedir?

Bir kol damarınızdan alınan kan numunesi kullanılır.

Test için Hazırlık Gerekir mi?

PSA düzeylerinin yükselmesiyle ilişkilendirildiğinden numune almadan önceki 24 saat içinde cinsel yolla boşalmadan kaçının. Ayrıca, doktor  parmakla rektal muayene (DRE) yapmadan önce veya prostat biyopsisinden  önce veya birkaç hafta geçmeden  PSA testi için kan numunesi almaktan kaçınmalıdır..  

Test Numunesi

Ne test edilmektedir?

PSA, birincil olarak prostat hücreleri tarafından üretilen bir  proteindir. Prostat erkeklerde üretrayı çevreleyen küçük bir organ olup ersuyunun bir bölümünü salgılamaktadır. Prostatın ürettiği PSA'nın çoğu bu meniye salınmakla birlikte küçük miktarlarda kan dolaşımına da geçmektedir. Kanda serbest (bağlı olmayan) ve kompleks (cPSA, proteine bağlı)  PSA formları bulunmaktadır. En sık kullanılan PSA testi, kanda serbest ve cPSA toplamını ölçen total PSA testidir. Doktor PSA testiyle total PSA testini kastetmektedir.

Prostat kanserini araştırmak ve takip için bir tümör belirteci olarak bu test kullanılmaktadır. İyi bir tanısal araç olmasına rağmen mükemmel bir araç değildir. Asemptomatik erkekleri tarama açısından bu testin yararlılığı hakkında uzmanlar arasında herhangi bir uzlaşı yoktur. Yükselmiş PSA düzeyleri prostat kanseriyle ilişkili olmasına rağmen prostat iltihabı (prostatit) ve iyi huylu prostat hiperplazisinde (BPH) de yüksek düzeyler görülebilmektedir. Erkeklerin hepsinde PSA düzeyleri yaşlandıkça artma eğilimindedir.

PSA, prostat  kanseri için tanısal değer taşımamaktadır. Prostat kanserini tanımlamada altın standart prostat biyopsisidir. Biyopside prostat dokusundan küçük numuneler toplanıp mikroskop altında anormal hücreler saptanır. Prostat biyopsisi gerekliliğini belirlemeye yardımcı olmak için total PSA testiyle birlikte  parmakla rektal muayene (DRE) yapılır. Tarama testinin hedefi gereksiz biyopsilerin sayısını en alt düzeye indirmek ve halen prostat içine sınırlıyken klinik açıdan anlamlı  prostat kanserini belirlemektir. Yaşlandıkça erkeklerde kanser oldukça sık görüldüğü, tümörlerin birçoğu yavaş büyüdüğü ve bu kanser tipi sık görülmeyen ölüm nedeni olduğu için "klinik açıdan anlamlı" terimi önemlidir. Doktorların hem prostat kanserini belirlemeye hem de yavaş büyüyen olgularla, agresif biçimde büyüyen ve vücudun diğer kısımlarına yayılabilen (metastaz yapan) prostat kanserleri arasında ayrım yapmaya çalışmaları gerekmektedir. Bugünlerde doktorlar abartılı tanı koyma ve tedavi  sorunlarıyla boğuşmaktadır. Bazı olgularda tedavi kanserden daha kötü sonuçlara, idrar kaçırma ve sertleşme sorunlarına yol açabilmektedir. PSA testi ve DRE prostat kanseri olgularının çoğunu saptayabilmesine rağmen genellikle kişinin hastalığının seyrini öngörememektedir.

Serbest  ve kompleks PSA (cPSA) ayrı ayrı istenebilir. Kanserle ilişkili olan ve olmayan PSA artışları arasında daha iyi ayrım yapabilmek için  testler geliştirilmiştir. Bu testlerin her ikisi prostat kanserli erkeklerde sık sık iki PSA formu arasındaki oranların değiştiği-azalmış serbest PSA ve artmış cPSA düzeyleri- ilkesine dayanmaktadır.

Test için numune nasıl toplanır?

Bir kol damarınızdan alınan kan numunesi kullanılır.

Numunenin kalitesinden emin olmak için herhangi bir test hazırlığına gerek var mı?

Yüksek PSA düzeyleriyle ilişkili olduğundan cinsel yolla boşaldıktan sonra 24 saat geçmeden numune alınmamalıdır. Ayrıca, doktor  parmakla rektal muayene (DRE) yapmadan önce veya prostat biyopsisinden önce veya birkaç hafta geçmeden  PSA testi için kan numunesi alınmamalıdır.  

Test

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Makalenin Kaynakları

« İlgili Sayfalara Geri dönün

NOT: Bu makale, burada söz edilen kaynaklarla birlikte Lab Tests Online Editörler İnceleme Kurulunun toplu deneyiminden yararlanan araştırmaya dayanmaktadır. Bu makale belli aralıklarla Editörler Kurulu tarafından gözden geçirilmekte ve inceleme sonuçlarına göre güncelleştirilebilmektedir. Alıntı yapılan her yeni kaynak listeye eklenecek ve kullanılan orijinal kaynaklardan ayırt edilecektir.

En son gözden geçirmede kullanılan kaynaklar

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Clarke, W. and Dufour, D. R., Editors (© 2006). Contemporary Practice in Clinical Chemistry: AACC Press, Washington, DC. Pp 243, 246.

Wu, A. (© 2006). Tietz Clinical Guide to Laboratory Tests, 4th Edition: Saunders Elsevier, St. Louis, MO. Pp 906-913.

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Daha önceki gözden geçirmede kullanılan kaynaklar

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