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KMID : 1001020090070020074
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Korean Journal of Urological Oncology
2009 Volume.7 No. 2 p.74 ~ p.81
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The Influence of Prostate Chronic Inflammation on Parameters Related to Prostate Cancer in Asymptomatic Patients
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Park Chang-Hoo
Kim Han-Gwun
Park Chang-Myun
Park Jong-Yeon
Kim Sung-Jin
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Abstract
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Purpose: We examined the effect of asymptomatic chronic prostatitis on total PSA (tPSA), free PSA (fPSA), PSA density (PSAD) and the ratio of free-to-total prostate specific antigen (%fPSA). And we investigated an association between chronic prostatitis and prostate cancer to avoid unnecessary second prostate biopsies.
Materials and Methods: Initial transrectal ultrasound-guided prostate biopsies from 143 patients with tPSA level of between 4 and 10ng/ml were performed. We evaluated them for the presence of cancer and presence, extent and aggressiveness of chronic inflammation. We correlated them with intial prostate related parameters.
Results: Chronic inflammation was present in 44 (95.7%) of 46 prostate cancer cases and in 90 (92.8%) of 97 non-cancer cases. In inflammation group, no significant difference was found in tPSA levels between cancer group and non-cancer groups, but on PSAD levels, significant increase was found in cancer group compared with non cancer group (0.23 vs 0.30, p＜0.001), fPSA (1.61 vs 0.75ng/ml, p=0.004) and %fPSA (25.10 vs 11.85, p=0.012) were decreased significantly. In both cancer and non-cancer groups, no signigicant differences were found in levels of prostate-related parameters between inflammation and non-inflammation groups. In both cancer and non-cancer groups, no signigicant changes were found in levels of prostate-related parameters according to extent and aggressiveness of inflammation.
Conclusions: Chronic inflammation can be related to elevation of tPSA level and may be a risk factor for prostate adenocarcinoma. The cut-off values of prostate related parameters are helpful to distinguish the cancer presence. The histologic review of inflammation is not helpful to decrease the unnecessary second prostate-biopsy.
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KEYWORD
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Prostate biopsy, Prostate cancer, Inflammation, PSA
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