Aykut ÇOLAKEROL, Mustafa Zafer TEMİZ, Çetin BORAN, Yavuz BAŞTUĞ, Engin KANDIRALI

Does serum prostate specific antigen levels correlate with the prostatic inflammation in elderly patients without clinically proven prostate cancer?

Objectives: To determine the whether histological prostatic inflammation correlates with serum prostate specific antigen (PSA), free PSA (fPSA) and percent of fPSA (%fPSA) levels in elderly patients without clinically proven prostate cancer. Methods: A total of 115 patients without clinically proven prostate cancer with transrectal prostate biopsy were included in this retrospective study. Patients were divided two main groups as patients with and without histologic prostatic inflammation. A grading of the histological prostatic inflammation was performed and patients with prostatic inflammation were divided into three subgroups. The age, prostate volume, serum PSA, fPSA and %fPSA levels were compared between patients with and without prostatic inflammation. Correlation between the parameters and grade of prostatic inflammation was also investigated. Results: Serum PSA and %fPSA levels were significantly higher in men with histologically proven prostatic inflammation (15.47 ± 15.28 ng/mL vs. 11.67 ± 8.12 ng/mL; p = 0.002 and 19.8 ± 0.7 vs. 15.79 ± 0.9; p = 0.01, respectively). The mean serum PSA levels were significantly different among the subgroups (p = 0.02) and prostatic inflammation correlated positively with the PSA levels (r = 0.320, p < 0.001). Conclusions: Our findings suggested that reporting the grade of prostatic inflammation in elderly patients may help avoiding unnecessary repeat biopsies if elevated serum PSA level is the only indication for initial prostate biopsy.

Keywords:

Inflammation, prostate, prostate specific antigen, elderly, men.,

PDF

___

1. Polascik TJ, Oesterling JE, Partin AW. Prostate specific antigen: a decade of discovery--what we have learned and where we are going. J Urol 1999;162:293-306.
2. Kawakami J, Siemens DR, Nickel JC. Prostatitis and prostate cancer: implications for prostate cancer screening. Urology 2004;64:1075-80.
3. Morote J, Lopez M, Encabo G, de Torres IM. Effect of inflammation and benign prostatic enlargement on total and percent free serum prostatic specific antigen. Eur Urol 2000;37:537-40.
4. Stimac G, Spajic B, Reljic A, Katusic J, Popovic A, Grubisic I, et al. Effect of histological inflammation on total and free serum prostate-specific antigen values in patients without clinically detectable prostate cancer. Korean J Urol 2014;55:527-32.
5. Okada K, Kojima M, Naya Y, Kamoi K, Yokoyama K, Takamatsu T, et al. Correlation of histological inflammation in needle biopsy specimens with serum prostate- specific antigen levels in men with negative biopsy for prostate cancer. Urology 2000;55: 892-8.
6. Fleshner NE, O'Sullivan M, Fair WR. Prevalence and predictors of a positive repeat transrectal ultrasound guided needle biopsy of the prostate. J Urol 1997;158:505-8; discussion 508-9.
7. Sano F, Uemura H. The utility and limitations of contrast-enhanced ultrasound for the diagnosis and treatment of prostate cancer. Sensors 2015;15:4947-57.
8. Ma Q, Yang DR, Xue BX, Wang C, Chen HB, Dong Y, et al. Transrectal real-time tissue elastography targeted biopsy coupled with peak strain index improves the detection of clinically important prostate cancer. Oncol Lett 2017;14:210-6.
9. Lee KS, Koo KC, Cho KS, Lee SH, Han WK, Choi YD, et al. Indications for a second prostate biopsy in patients suspected with prostate cancer after an initial negative prostate biopsy. Prostate Int 2017;5: 24-8.
10. Papsidero LD, Kuriyama M, Wang MC, Horoszewicz J, Leong SS, Valenzula L, et al. Prostate antigen: a marker for human prostate epithelial cells. J Natl Cancer Inst 1981;66:37- 42.
11. Irani J, Levillain P, Goujon JM, Bon D, Doré B, Aubert J. Inflammation in benign prostatic hyperplasia: correlation with prostate specific antigen value. J Urol 1997;157:1301-3.
12. Kwak C, Ku JH, Kim T, Park DW, Choi KY, Lee E, et al. Effect of subclinical prostatic inflammation on serum PSA levels in men with clinically undetectable prostate cancer. Urology 2003;62:854-9.
13. Ornstein DK, Smith DS, Humphrey PA, Catalona WJ. 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 1998;159:1234-7.
14. Hasui Y, Marutsuka K, Asada Y, Ide H, Nishi S, Osada Y. Relationship between serum prostate specific antigen and histological prostatitis in patients with benign prostatic hyperplasia. Prostate 1994;2:91-6.
15. Man LB, Li GZ, Huang GL, Wang JW, Liu BY. [Aggressiveness and extent of prostatic inflammation relates with serum PSA levels in type IV prostatitis]. Zhonghua Nan Ke Xue 2012;18:710-4. [articlre in Chinese]
16. Moreira DM, Nickel JC, Gerber L, Muller RL, Andriole GL, Castro-Santamaria R, et al. Baseline prostate inflammation is associated with a reduced risk of prostate cancer in men undergoing repeat prostate biopsy: results from the REDUCE study. Cancer 2014;120:190-6.
17. Kato T, Komiya A, Morii A, Iida H, Ito T, Fuse H. Analysis of repeated 24-core saturation prostate biopsy: Inverse association between asymptomatic histological inflammation and prostate cancer detection. Oncol Lett 2016;12:1132-8.
18. Simardi LH, Tobias-MacHado M, Kappaz GT, Taschner Goldenstein P, Potts JM, Wroclawski ER. Influence of asymptomatic histologic prostatitis on serum prostate-specific antigen: a prospective study. Urology 2004;64:1098-101.
19. Umbehr MH, Gurel B, Murtola TJ, Sutcliffe S, Peskoe SB, Tangen CM, et al. Intraprostatic inflammation is positively associated with serum PSA in men with PSA <4 ng/ml normal DRE and negative for prostate cancer. Prostate Cancer Prostatic Dis 2015;18:264-9.
20. Buddingh KT, Maatje MGF, Putter H, Kropman RF, Pelger RCM. Do antibiotics decrease prostate-specific antigen levels and reduce the need for prostate biopsy in type IV prostatitis? A systematic literature review. Can Urol Assoc J 2018;12:E25-30.

ISSN: 2149-3189
Yayın Aralığı: Yılda 6 Sayı
Başlangıç: 2015
Yayıncı: Prusa Medikal Yayıncılık Limited Şirketi

Arşiv