Zackrisson Björn, Ulleryd Peter, Aus Gunnar, Lilja Hans, Sandberg Torsten, Hugosson Jonas
Department of Urology, Sahlgrenska University Hospital, Göteborg, Sweden.
Urology. 2003 Aug;62(2):278-81. doi: 10.1016/s0090-4295(03)00372-8.
To determine the serum values of free, complexed, and total prostate-specific antigen (PSA) and their ratios in men with febrile urinary tract infection (UTI) during 1 year of follow-up.
A total of 54 men were prospectively enrolled in the study, and serum samples were obtained at the acute stage of the UTI and after 1, 3, 6, and 12 months.
Most men had a rise (median 3.1, 7.2, and 14.1 ng/mL, respectively) in free PSA (fPSA), complexed PSA (cPSA), and total PSA (tPSA) during the acute phase of the UTI. After 1 month, fPSA rapidly decreased to levels that were maintained during the rest of the follow-up period, and cPSA and tPSA declined more slowly. At 1, 3, and 6 months after the infection the fPSA/tPSA and fPSA/cPSA ratios were abnormal in one half to two thirds of the men (median ratio 11%, 15%, and 16% and 17%, 24%, and 24%, respectively), comparable to findings in patients with prostate cancer.
These results confirmed that the prostate is involved in men with febrile UTI. The low fPSA/tPSA and fPSA/cPSA ratios in combination with sustained elevations of cPSA and tPSA for up to 6 months after UTI could be falsely interpreted as a sign of prostate cancer. The prolonged elevation of cPSA indicates a long-lasting inflammation of the nonadenomatous parts of the prostate.
确定发热性尿路感染（UTI）男性患者在1年随访期间游离、复合及总前列腺特异性抗原（PSA）的血清值及其比率。
共有54名男性前瞻性纳入本研究，在UTI急性期以及1、3、6和12个月后采集血清样本。
大多数男性在UTI急性期游离PSA（fPSA）、复合PSA（cPSA）和总PSA（tPSA）升高（中位数分别为3.1、7.2和14.1 ng/mL）。1个月后，fPSA迅速降至随访期其余时间维持的水平，而cPSA和tPSA下降较慢。感染后1、3和6个月，一半至三分之二的男性fPSA/tPSA和fPSA/cPSA比率异常（中位数比率分别为11%、15%和16%以及17%、24%和24%），与前列腺癌患者的结果相当。
这些结果证实前列腺参与了发热性UTI男性患者的发病过程。UTI后长达6个月fPSA/tPSA和fPSA/cPSA比率低，同时cPSA和tPSA持续升高，可能会被错误地解读为前列腺癌的迹象。cPSA的长期升高表明前列腺非腺瘤部分存在持久炎症。
