Ukuhlolwa kwe-Free Prostate-Specific Antigen (f-PSA) kuyisisekelo sokuxilongwa kwesimanje komchamo, okudlala indima ebalulekile ekuhlolweni okuguquguqukayo kwengozi yomdlavuza wendlala yesinye. Ukubaluleka kwakho akulona njengethuluzi lokuhlola elizimele kodwa njengesengezo esibalulekile sohlolo oluphelele lwe-PSA (t-PSA), okuthuthukisa kakhulu ukunemba kokuxilonga nokuqondisa izinqumo zomtholampilo ezibalulekile, ngokuyinhloko ngokusiza ukugwema izinqubo ezingenasidingo zokuhlasela.

Inselele eyisisekelo ekuhlolweni komdlavuza wendlala yesinye ukuntuleka kokucaciswa kwe-t-PSA. Izinga eliphakeme le-t-PSA (ngokwesiko>4 ng/mL) lingabangelwa umdlavuza wendlala yesinye, kodwa futhi nezimo ezibucayi njenge-Benign Prostatic Hyperplasia (BPH) kanye ne-prostatitis. Lokhu kudala “indawo empunga yokuxilonga,” ikakhulukazi amanani e-t-PSA aphakathi kuka-4 no-10 ng/mL. Emadodeni akulolu hlu, isinqumo sokuthi aqhubeke yini ne-prostate biopsy—inqubo ehlaselayo enezingozi ezingaba khona njengokopha, ukutheleleka, nokungakhululeki—siba nzima. Kukulo mongo lapho ukuhlolwa kwe-f-PSA kufakazela inani layo elikhulu.

Ukubaluleka okuyinhloko kwe-f-PSA kusekwazini kwayo ukwenza ngcono ukuhlolwa kwengozi ngokusebenzisa isilinganiso se-f-PSA kuya ku-t-PSA (iphesenti le-PSA yamahhala). Ngokwe-biochemically, i-PSA ikhona egazini ngezindlela ezimbili: eboshelwe kumaprotheni futhi mahhala. Ucwaningo luye lwabonisa ngokungaguquki ukuthi ingxenye ye-f-PSA iphansi emadodeni anomdlavuza wendlala yesinye uma kuqhathaniswa nalawo ane-BPH. Amaseli ama-malignant athambekele ekukhiqizeni i-PSA engena egazini futhi abopheke kalula, okuholela emaphesentini aphansi efomu lamahhala. Ngokuphambene, ingxenye ephezulu ye-f-PSA ivame ukuhlotshaniswa nokukhuliswa okungalungile.

Lo mehluko we-biochemical usetshenziswa ngokomtholampilo ukubala iphesenti le-PSA yamahhala. Iphesenti eliphansi le-PSA lamahhala (isb., ngaphansi kuka-10-15%, nokuncishiswa kwangempela kuyahlukahluka) libonisa amathuba aphezulu omdlavuza wendlala yesinye futhi lithethelela ngokuqinile isincomo se-prostate biopsy. Ngokuphambene, amaphesenti aphezulu e-PSA yamahhala (isb, ngaphezulu kwama-20-25%) akhombisa amathuba aphansi okuba nomdlavuza, okuphakamisa ukuthi ukuphakama kwe-t-PSA kungenzeka kakhulu ngenxa ye-BPH. Ezimweni ezinjalo, udokotela angancoma ngokuzethemba isu lokugada okusebenzayo-okubandakanya ukuhlolwa okuphindaphindiwe kwe-PSA nokuhlolwa kwe-digital rectal ngokuhamba kwesikhathi-kunokuba i-biopsy esheshayo.

Ngakho-ke, umthelela owodwa obaluleke kakhulu wokuhlolwa kwe-f-PSA ukuncipha okukhulu kwe-prostate biopsies engadingekile. Ngokunikeza lolu lwazi olubucayi olubandlululayo, ukuhlolwa kusiza ukuvimbela inani elikhulu lamadoda ekungeneni kwenqubo yokuhlasela abangayidingi, ngaleyo ndlela kuncishiswe ukugula kwesiguli, kwehle izindleko zokunakekelwa kwempilo, futhi kudambise ukukhathazeka okubalulekile okuhlobene ne-biopsy kanye nokulinda imiphumela yayo.

Ngaphandle kwendawo yakudala engu-4-10 ng/mL empunga, i-f-PSA nayo ibalulekile kwezinye izimo: emadodeni ane-t-PSA eqhubekayo ekhuphuka naphezu kwe-biopsy engalungile yangaphambilini, noma nakulawo ane-t-PSA evamile kodwa ukuhlolwa kwe-digital rectal okungajwayelekile. Iya ngokuya ifakwa ezibalini zengozi yepharamethikhi eningi ukuze kuhlolwe okubanzi.

Sengiphetha, ukubaluleka kokuhlolwa kwe-f-PSA akukwazi ukweqiwa. Iguqula umphumela we-t-PSA ongaqondile, ongaqondile ube ithuluzi elinamandla nelihlakaniphe kakhulu lokuxilonga. Ngokuvumela ukuhlukaniswa kwengozi phakathi kwendawo empunga yokuxilonga, kunikeza amandla odokotela ukuthi benze izinqumo ezinolwazi, ezisekelwe ebufakazini, ekugcineni bathuthukise ukunakekelwa kwesiguli ngokunciphisa ngokuphepha ukuxilonga ngokweqile kanye nokwelashwa ngokweqile kuyilapho kuqinisekisa ukuthi amadoda asengozini enkulu ayahlonzwa futhi ahlolwe ngokushesha.