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International Urology and Nephrology

, Volume 43, Issue 2, pp 295–301 | Cite as

The correlation of extent and grade of inflammation with serum PSA levels in patients with IV prostatitis

  • LI Gui-zhong
  • Man LiboEmail author
  • Huang Guanglin
  • Wang Jianwei
Urology – Original Paper

Abstract

Objectives

The inflammation was categorized more profoundly, using the standardized histopathological classification system for chronic prostatitis of NIH, to determine the influence of prostatic inflammation on serum PSA levels.

Methods

The study included 120 patients who underwent transperineal ultrasound-guided prostate biopsy. The patients were divided into groups using 3 grades for the extent, the location and the aggressiveness of prostate inflammation. The serum tPSA levels, fPSA levels, %fPSA, and PSAD in each group were compared.

Results

Of 120 patients, 80 with benign prostatic tissue in their biopsy specimens met the inclusion criteria, excluding 40 cases with prostate cancer. The inflammation was present in 46(57.5%) of 80 cases. The extent of inflammation correlated positively with the total PSA level (r = 0.6, P < 0.001), fPSA (r = 0.5, P = 0.001) and PSAD (r = 0.6, P < 0.001). The grade of inflammation correlated positively with the total PSA level (r = 0.5, P < 0.001), fPSA (r = 0.4, P = 0.008) and PSAD (r = 0.7, P < 0.001). A negative correlation was found between the grade of inflammation and %fPSA (r = −0.4, P = 0.013).

Conclusions

If the elevation of serum PSA is thought to be caused by asymptomatic prostatitis with high aggressiveness score in BPH patients without clinical prostatitis, it might prevent unnecessary repeated biopsies.

Keywords

Prostate Prostate-specific antigen Prostatitis Pathology 

References

  1. 1.
    Polascik TJ, Oesterling JE, Partin AW (1999) Prostate specific antigen: a decade of discovery—what we have learned and where we are going. J Urol 162(2):293–306 Review. PubMed PMID: 10411025PubMedCrossRefGoogle Scholar
  2. 2.
    Sandhu JS (2009) Management of elevated prostate-specific antigen in men with nonbacterial chronic prostatitis. Curr Urol Rep 10(4):302–306 Review. PubMed PMID: 19570492PubMedCrossRefGoogle Scholar
  3. 3.
    Brawn PN, Speights VO, Kuhl D et al (1991) Prostate-specific antigen levels from completely sectioned, clinically benign, whole prostates. Cancer 68(7):1592–1599 PubMed PMID:1716510PubMedCrossRefGoogle Scholar
  4. 4.
    Irani J, Levillain P, Goujon JM, Bon D, Doré B, Aubert J (1997) Inflammation in benign prostatic hyperplasia: correlation with prostate specific antigen value. J Urol 157(4):1301–1303 PubMed PMID: 9120926PubMedCrossRefGoogle Scholar
  5. 5.
    Schatteman PH, Hoekx L, Wyndaele JJ, Jeuris W, Van Marck E (2000) Inflammation in prostate biopsies of men without prostatic malignancy or clinical prostatitis:correlation with total serum PSA and PSA density. Eur Urol 37(4):404–412 PubMed PMID: 10765070PubMedCrossRefGoogle Scholar
  6. 6.
    Yaman O, Göğüş C, Tulunay O, Tokatli Z, Ozden E (2003) Increased prostate-specific antigen in subclinical prostatitis: the role of aggressiveness and extension of inflammation. Urol Int 71(2):160–164 PubMed PMID: 12890953PubMedCrossRefGoogle Scholar
  7. 7.
    Simardi LH, Tobias-MacHado M, Kappaz GT, Taschner Goldenstein P, Potts JM, Wroclawski ER (2004) Influence of asymptomatic histologic prostatitis on serum prostate-specific antigen: a prospective study. Urology 64(6):1098–1101 PubMed PMID: 15596176PubMedCrossRefGoogle Scholar
  8. 8.
    Kwak C, Ku JH, Kim T, Park DW, Choi KY, Lee E, Lee SE, Lee C (2003) Effect of subclinical prostatic inflammation on serum PSA levels in men with clinically undetectable prostate cancer. Urology 62(5):854–859 PubMed PMID:14624908PubMedCrossRefGoogle Scholar
  9. 9.
    Kobayashi M, Nukui A, Morita T (2008) Serum PSA and percent free PSA value changes after antibiotic treatment a diagnostic method in prostate cancer suspects with asymptomatic prostatitis. Urol Int 80(2):186–192 Epub 2008 Mar 19. PubMed PMID: 18362491PubMedCrossRefGoogle Scholar
  10. 10.
    Kandirali E, Boran C, Serin E, Semercioz A, Metin A (2007) Association of extent and aggressiveness of inflammation with serum PSA levels and PSA density in asymptomatic patients. Urology 70(4):743–747 PubMed PMID: 17991548PubMedCrossRefGoogle Scholar
  11. 11.
    Ozden C, Ozdal OL, Guzel O, Han O, Seckin S, Memis A (2007) The correlation between serum prostate specific antigen levels and asymptomatic inflammatory prostatitis. Int Urol Nephrol 39(3):859–863 Epub 2006 Nov 17. PubMed PMID: 17111077PubMedCrossRefGoogle Scholar
  12. 12.
    Nickel JC, Roehrborn CG, O’Leary MP, Bostwick DG, Somerville MC, Rittmaster RS (2008) The relationship between prostate inflammation and lower urinary tract symptoms: examination of baseline data from the REDUCE trial. Eur Urol 54(6):1379–1384. Epub 2007 Nov 20. PubMed PMID: 18036719; PubMed Central PMCID:PMC2643127Google Scholar
  13. 13.
    Mettlin CJ, Murphy GP, Ho R, Menck HR (1996) The national cancer data base report on longitudinal observations on prostate cancer. Cancer 77(10):2162–2166 PubMed PMID: 8640686PubMedCrossRefGoogle Scholar
  14. 14.
    Schaeffer AJ (2002) Classification (traditional and National Institutes of Health) and demographics of prostatitis. Urology 60(6 Suppl):5–6 discussion 6–7. Review. PubMed PMID: 12521577PubMedCrossRefGoogle Scholar
  15. 15.
    Blumenfeld W, Tucci S, Narayan P (1992) Incidental lymphocytic prostatitis. Selective involvement with nonmalignant glands. Am J Surg Pathol 16(10):975–981 PubMed PMID: 1415905PubMedCrossRefGoogle Scholar
  16. 16.
    Gümüş BH, Neşe N, Gündüz MI, Kandiloglu AR, Ceylan Y, Büyüksu C (2004) Does asymptomatic inflammation increase PSA? A histopathological study comparing benign and malignant tissue biopsy specimens. Int Urol Nephrol 36(4):549–553 PubMed PMID: 15787334PubMedCrossRefGoogle Scholar
  17. 17.
    Serretta V, Catanese A, Daricello G, Liotta R, Allegro R, Martorana A, Aragona F, Melloni D (2008) PSA reduction (after antibiotics) permits to avoid or postpone prostate biopsy in selected patients. Prostate Cancer Prostatic Dis 11(2):148–152 Epub 2007 Jul 17. PubMed PMID: 17637759PubMedCrossRefGoogle Scholar
  18. 18.
    Liu L, Li Q, Han P, Li X, Zeng H, Zhu Y, Wei Q (2009) Evaluation of interleukin-8 in expressed prostatic secretion as a reliable biomarker of inflammation in benign prostatic hyperplasia. Urology 74(2):340–344 Epub 2009 May 22. PubMed PMID: 19464042PubMedCrossRefGoogle Scholar
  19. 19.
    Begley LA, Kasina S, MacDonald J, Macoska JA (2008) The inflammatory microenvironment of the aging prostate facilitates cellular proliferation and hypertrophy. Cytokine 43(2):194–199. Epub 2008 Jun 24. PubMed PMID:18572414; PubMed Central PMCID: PMC2538565Google Scholar
  20. 20.
    Morote J, Lopez M, Encabo G, de Torres IM (2000) Effect of inflammation and benign prostatic enlargement on total and percent free serum prostatic specific antigen. Eur Urol 37(5):537–540 PubMed PMID: 10765091PubMedCrossRefGoogle Scholar
  21. 21.
    Ornstein DK, Smith DS, Humphrey PA, Catalona WJ (1998) The effect of prostate volume, age, total prostate specific antigen level and acute inflammation on the percentage of free serum prostate specific antigen levels in men without clinically detectable prostate cancer. J Urol 159(4):1234–1237 PubMed PMID: 9507843PubMedCrossRefGoogle Scholar
  22. 22.
    Ornstein DK, Smith DS, Humphrey PA, Catalona WJ (1998) The effect of prostate volume, age, total prostate specific antigen level and acute inflammation on the percentage of free serum prostate specific antigen levels in men without clinically detectable prostate cancer. J Urol 159(4):1234–1237 PubMed PMID: 9507843PubMedCrossRefGoogle Scholar
  23. 23.
    Wise GJ, Marella VK, Talluri G, Shirazian D (2000) Cytokine variations in patients with hormone treated prostate cancer. J Urol 164(3 Pt 1):722–725 PubMed PMID: 10953133PubMedGoogle Scholar
  24. 24.
    Terakawa T, Miyake H, Kanomata N, Kumano M, Takenaka A, Fujisawao M (2008) Inverse association between histologic inflammation in needle biopsy specimens and prostate cancer in men with serum PSA of 10–50 ng/mL. Urology 72(6):1194–1197 Epub 2008 Oct 1. PubMed PMID: 18829081PubMedCrossRefGoogle Scholar
  25. 25.
    Terris MK, Stamey TA (1991) Determination of prostate volume by transrectal ultrasound. J Urol 145(5):984–987 PubMed PMID: 2016815PubMedGoogle Scholar

Copyright information

© Springer Science+Business Media, B.V. 2010

Authors and Affiliations

  • LI Gui-zhong
    • 1
  • Man Libo
    • 1
    Email author
  • Huang Guanglin
    • 1
  • Wang Jianwei
    • 1
  1. 1.Department of UrologyBeijing Jishuitan HospitalBeijingChina

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