Does an increase in PSA necessarily mean prostate cancer?

Prostate cancer is a very important type of male reproductive system tumor. With the aging of my country's population and the improvement of medical diagnosis technology, the incidence of prostate tumors is gradually increasing. Prostate-specific antigen (PSA) plays an important role in the diagnosis of prostate tumors.

PSA is the most specific tumor marker for prostate cancer. It is a serine protease secreted by prostate epithelial cells. Under normal circumstances, there is a barrier consisting of endothelial layer, basal cell layer and basement membrane between the PSA-rich prostate acinar contents and the lymphatic system. When tumors or other lesions destroy this barrier, the glandular duct contents can leak into the lymphatic system and then enter the blood circulation, leading to an increase in peripheral blood PSA levels. PSA is only a marker for prostate epithelial cells, not a marker for prostate cancer.

Therefore, in addition to prostate cancer, benign prostatic hyperplasia, prostatic inflammatory lesions, etc. can also cause PSA to rise. Therefore, when PSA rises, we need to evaluate the patient's overall condition and rule out factors such as prostatitis and mechanical stimulation that cause PSA to rise.