Department of Urology, Lanzhou General Hospital, Lanzhou Command, PLA, Lanzhou, Gansu, China.
Urology. 2011 Mar;77(3):688-92. doi: 10.1016/j.urology.2010.07.493. Epub 2010 Oct 25.
To reveal the correlation between benign prostatic hyperplasia (BPH) histologic inflammation and serum prostate-specific antigen (sPSA) concentrations, and the possible mechanism.
Patients underwent surgery at the Urology Department of West China Hospital of Sichuan University were retrospectively studied. Preoperative sPSA and transrectal ultrasonography were measured. According to the histopathological classification system for chronic prostatic inflammation proposed by the Chronic Prostatitis Collaborative Research Network (CPCRN) and the International Prostatitis Collaborative Network (IPCN), we classified the histologic sections of prostatic biopsy into glandular, periglandular, and stromal inflammation by the anatomical location of inflammatory infiltration. The glandular inflammation was graded according to the inflammatory aggressiveness. The periglandular and stromal inflammation were graded according to the inflammatory density. The correlation between histologic inflammation and sPSA was studied by a multiple regression model in conjunction with age and total prostatic volume.
A total of 454 patients with exclusively BPH were analyzed. The periglandular inflammatory infiltration was the most common pattern (95.6%). Single regression analysis revealed that total prostatic volume, the aggressiveness of glandular inflammation, and the intensity of periglandular and stromal inflammation were correlated with sPSA. However, the multiple regression analysis revealed that only the total prostatic volume and the aggressiveness of glandular inflammation were correlated significantly with sPSA (R = .389, 0.289; P = .000).
The aggressiveness of glandular inflammatory infiltration in BPH is a significant contributor to elevated sPSA levels. The theory of leakage may be the most reasonable mechanism to reveal the correlation morphologically. We should take inflammation into consideration when interpreting the abnormal elevating of sPSA levels.
揭示良性前列腺增生（BPH）组织学炎症与血清前列腺特异性抗原（sPSA）浓度之间的相关性及其可能的机制。
回顾性分析了在四川大学华西医院泌尿外科接受手术的患者。术前测量 sPSA 和经直肠超声。根据慢性前列腺炎协作研究网络（CPCRN）和国际前列腺炎协作网络（IPCN）提出的慢性前列腺炎组织学炎症分类系统，我们根据炎症浸润的解剖位置将前列腺活检组织的组织学切片分为腺体、腺体周围和基质炎症。根据炎症侵袭性对腺体炎症进行分级。根据炎症密度对腺体周围和基质炎症进行分级。通过多元回归模型结合年龄和前列腺总体积研究组织学炎症与 sPSA 之间的相关性。
共分析了 454 例单纯 BPH 患者。腺体周围炎症浸润最常见（95.6%）。单因素回归分析显示，前列腺总体积、腺体炎症的侵袭性以及腺体周围和基质炎症的强度与 sPSA 相关。然而，多元回归分析显示，只有前列腺总体积和腺体炎症的侵袭性与 sPSA 显著相关（R =.389，0.289；P =.000）。
BPH 中腺体炎症浸润的侵袭性是导致 sPSA 水平升高的重要因素。渗漏理论可能是揭示这种相关性的最合理机制。在解释 sPSA 水平异常升高时，我们应该考虑炎症因素。
