无症状患者炎症程度及侵袭性与血清前列腺特异抗原水平和前列腺特异抗原密度的相关性

Association of extent and aggressiveness of inflammation with serum PSA levels and PSA density in asymptomatic patients.

作者信息

Kandirali Engin, Boran Cetin, Serin Erdinc, Semercioz Atilla, Metin Ahmet

机构信息

Department of Urology, Abant Izzet Baysal University, Izzet Baysal Medical Faculty, Bolu, Turkey.

出版信息

Urology. 2007 Oct;70(4):743-7. doi: 10.1016/j.urology.2007.06.1102.

DOI:10.1016/j.urology.2007.06.1102

PMID:17991548

Abstract

OBJECTIVES

The relationship between serum prostate-specific antigen (PSA) levels and histologic prostatic inflammation is controversial. Previous studies were performed using either the intensity or extent of inflammation for grading, with a relatively lower number of specimens. In our study, the inflammation was categorized more profoundly, using both the intensity and the extent of inflammation, to determine the influence of prostatic inflammation on serum PSA levels, percent free PSA (%fPSA), and PSA density (PSAD).

METHODS

The study included 115 patients who underwent transrectal ultrasound-guided prostate biopsy. To categorize the inflammation, a grading method that included the intensity and extent of inflammation was used. The extent and aggressiveness of inflammation were analyzed. The patients were divided into groups using five grades for the extent and four grades for the aggressiveness of inflammation. The serum PSA levels, fPSA levels, %fPSA, and PSAD in each group were compared.

RESULTS

The extent of inflammation grade correlated positively with the serum PSA level (r = 0.423, P <0.001) and PSAD (r = 0.319, P = 0.001). However, a negative correlation was found between the extent of inflammation grade and %fPSA (r = -0.268, P = 0.015). The aggressiveness of inflammation grade correlated positively with the serum PSA level (r = 0.386, P <0.001) and PSAD (r = 0.341, P = 0.001) and negatively with %fPSA (r = -0.289, P = 0.03).

CONCLUSIONS

If the elevation of serum PSA is thought to be caused by histologic inflammation, it might prevent unnecessary repeated biopsies.

摘要

目的

血清前列腺特异性抗原（PSA）水平与前列腺组织学炎症之间的关系存在争议。以往研究在分级时要么采用炎症强度，要么采用炎症范围，且样本数量相对较少。在我们的研究中，对炎症进行了更深入的分类，同时采用炎症强度和范围来确定前列腺炎症对血清PSA水平、游离PSA百分比（%fPSA）和PSA密度（PSAD）的影响。

方法

该研究纳入了115例行经直肠超声引导下前列腺穿刺活检的患者。为了对炎症进行分类，采用了一种包括炎症强度和范围的分级方法。分析炎症的范围和侵袭性。根据炎症范围的五个等级和炎症侵袭性的四个等级将患者分组。比较每组患者的血清PSA水平、fPSA水平、%fPSA和PSAD。

结果

炎症范围分级与血清PSA水平（r = 0.423，P <0.001）和PSAD（r = 0.319，P = 0.001）呈正相关。然而，炎症范围分级与%fPSA呈负相关（r = -0.268，P = 0.015）。炎症侵袭性分级与血清PSA水平（r = 0.386，P <0.001）和PSAD（r = 0.341，P = 0.001）呈正相关，与%fPSA呈负相关（r = -0.289，P = 0.03）。