Hochreiter W W
Hirslanden Clinic, Aarau, Switzerland.
Andrologia. 2008 Apr;40(2):130-3. doi: 10.1111/j.1439-0272.2007.00820.x.
Elevated levels of prostate-specific antigen (PSA) in men may result from a variety of causes, such as prostate cancer, benign prostatic hyperplasia, acute urinary tract infection, and bacterial prostatitis. In recent years, several studies have also demonstrated a relationship between chronic prostatitis/chronic pelvic pain syndrome and increased PSA levels. However, asymptomatic patients are not routinely screened for this diagnosis before transrectal biopsy is performed to rule out prostate cancer. These asymptomatic men with elevated PSA levels frequently have evidence of inflammation when their expressed prostatic secretions are examined, or on their prostate biopsy specimens. This raises the problem of appropriate evaluation in the presence of chronic prostatitis and elevated PSA levels--not only in prostate cancer screening programmes, but also in cancer-negative biopsy findings. Evidence from the literature indicates that antimicrobial treatment may lower the PSA levels to what is considered the normal range. Despite that, general recommendations for the practical management are lacking and undetected prostate cancer in men with chronic prostatitis remains a difficult issue.
男性前列腺特异性抗原（PSA）水平升高可能由多种原因引起，如前列腺癌、良性前列腺增生、急性尿路感染和细菌性前列腺炎。近年来，多项研究还表明慢性前列腺炎/慢性盆腔疼痛综合征与PSA水平升高之间存在关联。然而，在进行经直肠活检以排除前列腺癌之前，通常不会对无症状患者进行该诊断的常规筛查。这些PSA水平升高的无症状男性在检查其前列腺分泌物或前列腺活检标本时，常常有炎症迹象。这就引发了在存在慢性前列腺炎和PSA水平升高的情况下进行适当评估的问题——不仅在前列腺癌筛查项目中如此，在活检结果为癌症阴性的情况下也是如此。文献证据表明，抗菌治疗可能会将PSA水平降至被认为是正常范围的值。尽管如此，目前仍缺乏实际管理的通用建议，慢性前列腺炎男性中未被发现的前列腺癌仍然是一个难题。
