Kwak Cheol, Ku Ja Hyeon, Kim Taehun, Park Dal Woo, Choi Ki Young, Lee Eunsik, Lee Sang Eun, Lee Chongwook
Department of Urology, Seoul National University College of Medicine, Seoul, South Korea.
Urology. 2003 Nov;62(5):854-9. doi: 10.1016/s0090-4295(03)00688-5.
To examine whether subclinical prostatic inflammation might influence serum prostate-specific antigen (PSA) levels in men with clinically undetectable prostate cancer.
A total of 461 patients who underwent prostate biopsy at our hospital were studied between January 1996 and December 1999. Of these patients, a total of 125 patients without detectable prostate cancer or a history or symptoms of prostatitis, with serum PSA levels of less than 20.0 ng/mL and other specified exclusion criteria, were included in the study. Inflammation observed at biopsy was scored for inflammation extent and inflammatory aggressiveness, and the effects of these morphologic aspects of inflammation on serum PSA levels were examined.
The extent of inflammation tended to increase as the prostate volume increased (P = 0.006). Patients with a PSA greater than 2.5 ng/mL had a greater extent and aggressiveness of inflammation than those with PSA levels of 2.5 ng/mL or less (P = 0.004 and P = 0.050, respectively). However, no statistically significant differences were found in terms of the extent of inflammation or inflammatory aggressiveness between patients with PSA levels greater than 4.0 ng/mL and those with PSA levels of 4.0 ng/mL or less. Furthermore, the extent of inflammation did not account for PSA levels greater than 2.5 or 4.0 ng/mL by multivariate analysis.
Our results indicate that subclinical prostatic inflammation is not the etiology of a serum PSA greater than 4.0 ng/mL in men without clinically detectable prostate cancer.
探讨亚临床前列腺炎症是否会影响临床未检测到前列腺癌的男性的血清前列腺特异性抗原（PSA）水平。
对1996年1月至1999年12月期间在我院接受前列腺活检的461例患者进行研究。其中，共有125例未检测到前列腺癌、无前列腺炎病史或症状、血清PSA水平低于20.0 ng/mL且符合其他特定排除标准的患者纳入研究。对活检时观察到的炎症进行炎症程度和炎症侵袭性评分，并研究炎症的这些形态学方面对血清PSA水平的影响。
炎症程度倾向于随着前列腺体积的增加而增加（P = 0.006）。PSA大于2.5 ng/mL的患者比PSA水平为2.5 ng/mL或更低的患者具有更大的炎症程度和侵袭性（分别为P = 0.004和P = 0.050）。然而，PSA水平大于4.0 ng/mL的患者与PSA水平为4.0 ng/mL或更低的患者在炎症程度或炎症侵袭性方面未发现统计学上的显著差异。此外，多因素分析显示炎症程度并不能解释PSA水平大于2.5或4.0 ng/mL的情况。
我们的结果表明，亚临床前列腺炎症不是临床未检测到前列腺癌的男性血清PSA大于4.0 ng/mL的病因。
