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Effects of Chronic Bacterial Prostatitis on Prostate Specific Antigen Levels Total and Free in Patients with Benign Prostatic Hyperplasia and Prostate Cancer


Background: Prostatic-specific antigen (PSA), a tumor marker helpful in the diagnosis and follow-up of prostate cancer, may rise due to causes such as prostatitis, chronic benign prostatic hyperplasia (BHP), etc. The aim of this study was to investigate the relationship between prostatitis and the level of total and free prostate-specific antigen in patients with no clinical evidence of prostate cancer. Methods: A comprehensive urological examination was performed on 156 patients aged 35–61 years old. All patients have symptoms of prostatitis. Prostate fluid culture was preformed. All patients underwent a course of antibacterial treatment after which the levels of total prostate specific antigen (TPSA) and free prostate specific antigen (FPSA) were evaluated. Results: An increase in TPSA (>4 ng/ml) was observed in 14/24 (58.3%) patients with acute prostatitis and in 7/45 (15.5%) and 4/44 (9.1%) in patients with chronic bacterial prostatitis (CBP) and a bacterial prostatitis, respectively. Low blood concentration of TPSA and FPSA were observed after effective antibacterial and anti-inflammatory treatment therapy in most cases. Conclusion: These data suggested that prostatitis must be considered when interpretation of TPSA and FPSA values as tumor marker.

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  1. 1.

    MS Ltwin M McNaughton-Collins FJ Fowwler SuffixJr. (1999) ArticleTitleThe National institute of Health care symptoms index: development and validation of a new outcome measures, Chronic Prostatitis Collaborative Research Network J Urol 162 IssueID2 369

  2. 2.

    MM Collins RS Stafford MP. O’Leary (1998) ArticleTitleHow common is prostatitis/A national survey visits J Urol 159 IssueID4 1224 Occurrence Handle1:STN:280:DyaK1c7mslamug%3D%3D Occurrence Handle9507840

  3. 3.

    EM. Mears (1999) ArticleTitleProstatitis: a review Urology 162 IssueID2 369

  4. 4. Prostatitis Adult and chronic Urology. 2004; 1–2.

  5. 5.

    Ahuja SK. Chronic Bacterial Prostatitis. 2002; 1–14.

  6. 6.

    J Dalton J. Morote (1989) ArticleTitleElevated serum prostate-specific antigen due to acute bacterial prostatitis Urol. 34 IssueID4 373

  7. 7.

    V Pansadoro P Emiliozzi L Defidio et al. (1996) ArticleTitleProstate-specific antigen and prostatitis in men under fifty Eur Urol 30 IssueID1 24 Occurrence Handle1:STN:280:ByiD3cnnvVM%3D Occurrence Handle8854063

  8. 8.

    S Resim M Cez ZG Gurbuz et al. (1999) ArticleTitleSerum PSA and age-specific reference ranges in patients with prostatism symptoms Int Urol Nephrol 31 IssueID2 221 Occurrence Handle10.1023/A:1007132926635 Occurrence Handle1:STN:280:DyaK1MvgvFKqsQ%3D%3D Occurrence Handle10481967

  9. 9.

    JM. Potts (2001) ArticleTitleThe four categories of prostatitis: a practical approach to treatment Cleve Clin J Med 68 IssueID5 389–390 Occurrence Handle1:STN:280:DC%2BD3M3ltl2huw%3D%3D Occurrence Handle11352318

  10. 10.

    EB Mazo ME Grigor’ev AB. Stepenskii (2001) ArticleTitleEffect of chronic bacterial prostatitis on changes in concentration of free and total prostatic specific antigen in the serum and urine from patients with benign prostatic hyperplasia and prostatic cancer Urologiia 5 3–7 Occurrence Handle11641977

  11. 11.

    WJ Catalona TL Smith Ratliff et al. (1991) ArticleTitleMeasurement of prostate-specific antigen in serum as a screening test for prostate cancer N Engl J Med 324 1156 Occurrence Handle1:STN:280:By6C1cjgslY%3D Occurrence Handle1707140

  12. 12.

    JE. Oestrling (1991) ArticleTitleProstate-specific antigen: a critical assessment of the most useful tumor marker for adenocarcinoma of the prostate J Urol. 145 907

  13. 13.

    SJ Jacobsen SK Katusic Bergstraih et al. (1995) ArticleTitleIncidence of prostate cancer diagnosis in the eras before and after serum prostate-specific antigen testing JAMA 274 1445 Occurrence Handle10.1001/jama.274.18.1445 Occurrence Handle1:STN:280:BymD2Mrgt1c%3D Occurrence Handle7474190

  14. 14.

    JE Oestrling SJ. Jacobsen (1993) ArticleTitleSerum prostate-specific antigen in community-based population of healthy men: Establishment of age-specific reference ranges JAMA 270 860

  15. 15.

    JE Oesterling WH. Cooner (1993) ArticleTitleInfluence of patient age on serum PSA concentration: an important clinical observation Urol Clin North Am 20 67

  16. 16.

    MA Hudson RR. Bahnson (1989) ArticleTitleClinical use prostate specific antigen in patients with prostate cancer J Urol 142 1011 Occurrence Handle1:STN:280:By%2BD3M3jslU%3D Occurrence Handle2477559

  17. 17.

    RG Nixon JD Lilly RJ Liedtke JD. Batjer (1997) ArticleTitleVariation of free and total prostate-specific antigen levels: the effect on the percent free/total-specific antigen Arch Pathol Lab Med Northfield 121 IssueID4 385 Occurrence Handle1:CAS:528:DyaK2sXmt1SktLY%3D

  18. 18.

    Ch M Niederau R Beyrau E Gurr et al. (1998) ArticleTitleExternal evaluation of tumor markers on elesys 1010 immunoanalyzer Tumor Marker Onco 13 IssueID2 29

  19. 19.

    Isenberg H. Clinical Microbiology Procedures Handbook. Washington DC: ASM. 1, 1992.

  20. 20.

    ST. Cowan (1994) Manual for the Identification of Medical Bacteria Cambridge University press London

  21. 21.

    DA Leigh K. Simmons (1997) ArticleTitleIdentification of non-sporing anaerobic bacteria J Clin Path 7 IssueID30 991

  22. 22.

    EJO Baron LR Peterson SM. Finegold (1994) Bailey and Scott’s diagnostic microbiology Mosbey Missouri

  23. 23.

    National (US) Committee for clinical Laboratory Standards: Performance standards for antimicrobial disk susceptibility tests. NCCLS 1993; 13(24).

  24. 24.

    R Steel JH. Torrie (1980) Principle and procedures of statistics McGraw-Hill Book Co. New York

  25. 25.

    TA Stamy N Yang AR Hay et al. (1987) ArticleTitleProstate-specific antigen as a serum marker for adenocarcinoma of the prostate N Engl J Med 317 909

  26. 26.

    TG Armitage EH. Cooper (1988) ArticleTitleThe value of the measurement of serum prostate-specific antigen in patients with benign prostatic hypereplasia and untreated prostate cancer Br J Urol 62 584 Occurrence Handle1:STN:280:BiaC3Mfos1U%3D Occurrence Handle2464397

  27. 27.

    PD Sershon MJ Barry JE. Oestrling (1993) ArticleTitleSerum PSA values in men with histologically confirmed BPH versus patients with organ-confined prostate cancer J Urol 149 421A

  28. 28.

    OH Lange CJ. Ercole (1989) ArticleTitleThe value of serum prostate specific antigen determinations before and after radical prostatectomy J Urol 141 873 Occurrence Handle1:STN:280:BiaC2sfptVQ%3D Occurrence Handle2467013

  29. 29.

    L Dalkin F. Ahman (1993) ArticleTitleDerivation of normal prostate specific antigen (PSA) level by age J Urol 149 413A

  30. 30.

    MNG. Battikhi (2003) ArticleTitleAge-specific reference ranges for prostate-specific (PSA) antigen in Jordanian patients Prostate Cancer Prostate Dis 6 56

  31. 31.

    ED Crawford (1993) ArticleTitleReport on the 1992 Prostate Cancer Awareness Week J Urol 149 55A

  32. 32.

    C Martin A Weinrich ST Jacobsen et al. (1998) ArticleTitleReference ranges for serum prostate-specific antigen in black and white men without cancer Urol 52 967

  33. 33.

    R Sawyer JJ Berman A Borkowski MG. William (1996) ArticleTitleElevated prostate-specific antigen levels in black men and white men Mod Pathol 9 1029 Occurrence Handle1:STN:280:ByiD1cjltVw%3D Occurrence Handle8933511

  34. 34.

    JH Hwang HY Tsai TC. Liu (2002) ArticleTitleCommunity-acquired methicillin-resistat Staphylococcus aureus infections in discharing ears Acta Otolaryngol 122 IssueID8 827 Occurrence Handle10.1080/0036554021000028076 Occurrence Handle1:CAS:528:DC%2BD3sXns1emtg%3D%3D Occurrence Handle12542200

  35. 35.

    Y Rakover A Smuskovitz R Colodner et al. (2000) ArticleTitleDuration of antibacterial effectiveness of gentamicin ear drops in external otitis J Laryngol Otol 114 IssueID11 827 Occurrence Handle1:STN:280:DC%2BD3M7gsFCmsA%3D%3D Occurrence Handle11144828

  36. 36.

    Y Matsumoto Y Suzuki Y Ishii et al. (1998) ArticleTitleAntimicrobial activity of ofloxacin against recent clinical isolates from otitis media and otitis externa Japan J Antibiot 51 IssueID9 561 Occurrence Handle1:STN:280:DyaK1M%2Fmt1OisQ%3D%3D

  37. 37.

    W. Elias (2002) ArticleTitleCurrent therapeutic management, new antibiotics and treatment of Pseudomonas aeruginosa in bacterial ENT infections Laryngorhinootolgie 81 IssueID1 40

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Correspondence to Mohammed Nizar G. Battikhi.

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Battikhi, M.N.G., Ismail, H. & Battikhi, Q. Effects of Chronic Bacterial Prostatitis on Prostate Specific Antigen Levels Total and Free in Patients with Benign Prostatic Hyperplasia and Prostate Cancer. Int Urol Nephrol 38, 21–26 (2006).

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  • Prostatitis
  • Total
  • Free prostate specific antigen and their ratio