Prostate-specific antigen in females: A new tool?

We read with interest the article1 depicting the use of prostate-specific antigen (PSA) as a diagnostic tool in polycystic ovarian disease. While serum PSA levels in females are much lower than in males, and often need ultrasensitive immunoassays for quantification,2 their importance cannot be overlooked. Indeed, PSA has come up as a potential serological diagnostic and prognostic tool in women recently. Increased levels of serum PSA has been detected in women with breast cysts and fibroadenoma3 and is also thought to be a prognostic marker in women with metastatic breast cancer treated with megestrol acetate.4 However, the levels of PSA in malignant breast tissue have been found to be lower than in normal breast tissue or benign hyperplasia.5 The value of PSA also increases in carcinoma of the female prostate (Skene's gland).6 PSA has been detected in amniotic fluids7 with the levels varying with gestational age and hence it has been suggested as a candidate growth factor.78

Thus, while much remains to be known about the biology of the physiological function of PSA in females, evidence indicates that it may emerge as a robust serological tool in near future for diagnosis and prognosis of many disorders.