Yaman Onder, Göğüş Cağatay, Tulunay Ozden, Tokatli Zafer, Ozden Eriz
Department of Urology, Ankara University, School of Medicine, Ankara, Turkey.
Urol Int. 2003;71(2):160-4. doi: 10.1159/000071839.
Subclinical prostatitis is a very frequent histologic finding in pathological examinations of prostate biopsy and prostate surgery material. In this study, we tried to investigate the correlation between the morphological parameters of histological prostatitis and total serum prostate-specific antigen (PSA)-PSA density (PSAD) to determine if either the extent or aggressiveness of inflammation might affect serum PSA.
269 patients who had undergone TURP or transvesical prostatectomy with pathological diagnosis of BPH and prostatitis were included in the study. We retrospectively reviewed and scored the extent and aggressiveness of inflammation in prostate specimens of BPH, according to the scale that has been reported by Irani et al. and then correlated those scores with PSA and PSAD.
When the inflammation grades correlated with PSA and PSAD, the extent of the inflammation did not show a significant correlation with total PSA and PSAD (p > 0.05). However, there was a statistically significant correlation between aggressiveness grades and total PSA and PSAD (p < 0.001). Median PSA levels in grades 0, 1 and 2 of aggressiveness of inflammation were 3.2, 4.2 and 5.8 respectively.
Aggressiveness grade of the inflammation in subclinical prostatitis is the most important morphological factor that is responsible for PSA elevation. We believe that it should be a more accurate guide for the clinician if pathologists report on the aggressiveness grades of the inflammation, especially on initial prostate biopsies, in order to help for timing of the further biopsy.
亚临床前列腺炎是前列腺活检和前列腺手术材料病理检查中非常常见的组织学发现。在本研究中，我们试图研究组织学前列腺炎的形态学参数与血清总前列腺特异性抗原（PSA）-PSA密度（PSAD）之间的相关性，以确定炎症的程度或侵袭性是否会影响血清PSA。
本研究纳入了269例经病理诊断为良性前列腺增生（BPH）和前列腺炎且接受了经尿道前列腺切除术（TURP）或经膀胱前列腺切除术的患者。我们根据Irani等人报道的量表，回顾性地对BPH前列腺标本中炎症的程度和侵袭性进行评分，然后将这些评分与PSA和PSAD进行相关性分析。
当炎症分级与PSA和PSAD相关时，炎症程度与总PSA和PSAD之间未显示出显著相关性（p>0.05）。然而，侵袭性分级与总PSA和PSAD之间存在统计学显著相关性（p<0.001）。炎症侵袭性0级、1级和2级的PSA中位数水平分别为3.2、4.2和5.8。
亚临床前列腺炎中炎症的侵袭性分级是导致PSA升高的最重要形态学因素。我们认为，如果病理学家报告炎症的侵袭性分级，尤其是在初次前列腺活检时，这对临床医生来说应该是一个更准确的指导，有助于确定进一步活检的时机。
