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KMID : 0358320060470010031
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Korean Journal of Urology
2006 Volume.47 No. 1 p.31 ~ p.36
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Elevation of Serum Prostate Specific Antigen in Subclinical Prostatitis: The Role of Pathology of Inflammation
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Lee Seung-Eon
Cho In-Rae
Lee Keon-Cheol
Kim Han-Seong
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Abstract
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Purpose: We evaluated the correlation of the pathologic diagnosis, including the grade or location of the inflammation on a prostate biopsy specimen, to the serum prostate-specific antigen(PSA) level.
Materials and Methods: 172 patients(the patients’ PSA was≥4ng/ml) who received prostate biopsy at our department from January 2000 to August 2003 were retrospectively studied. The pre-biopsy PSA and pathology, including the diagnoses and inflammatory patterns, were analyzed. The pathologic patterns of inflammation were divided as acute or chronic by the predominant inflammatory cell type; especially, the chronic inflammation was divided by grade or location, and then this was reviewed by 1 pathologist. Chronic Inflammation was graded as I, II or III according to the severity of inflammation. The PSA levels were compared among the grades. The presence or absence of chronic inflammation was checked in the periglandular, stromal and perivascular areas, respectively. The PSA levels were compared between the presence and absence of inflammation at each location.
Results: Among 172 patients, the number of patients with prostate cancer was 37(21.5%), and 68 patients had only BPH(39.5%), 27 had only prostatitis(15.7%) and 40 patients had benign prostatic hyperplasia(BPH) with prostatitis(23.3%). The number of patients with any prostatitis was 67(39.0%). The age of the patients was 68.4-8.7 years(45-91), the serum PSA was 13.30-14.38ng/ml(4.30-102.48), and the prostate size was 49.5-21.1ml(20-126). One case of BPH with prostatitis had a PSA level above 100ng/ml. Among the 67 specimens that showed prostatitis, 16 patients had histologically acute inflammation(23.9%) and 51 patients had chronic inflammation(76.1%). The PSA levels of the acute or chronic inflammation patients were 24.04-25.95ng/ml(4.46-102.48) and 9.93-4.73ng/ml(4.3- 21.12, p=0.047), respectively. The PSA levels were not different among the 3 grades of chronic inflammation. In periglandular, stromal and perivascular locations, the PSA levels were not different between the presence and absence of chronic inflammation.
Conclusions: About 39% of the prostate biopsy specimens showed prostatitis. The PSA level was higher for the acute inflammation than for the chronic inflammation. However, there was no difference in PSA levels among the each of the grades or locations of chronic prostatic inflammation. (Korean J Urol 2006;47:31-36)
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KEYWORD
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Prostatitis, Prostate-specific antigen, Pathology
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