Unité Médicale d'Oncologie Moléculaire et Transfert, Centre Hospitalier Lyon Sud, Hospices Civils de Lyon, Lyon, France.
Prostate. 2012 Apr;72(5):549-54. doi: 10.1002/pros.21457. Epub 2011 Jul 14.
The influence of chronic prostatitis on serum PSA level is well known. Whether it also influences potential new biomarkers of prostate cancer (PCa) has to be determined. We conducted a prospective study to evaluate the effect of chronic prostatitis on the PCa urinary marker PCA3.
Included were 38 patients, mean-aged of 37.5 years, with clinical suspicion of chronic prostatitis. A simplified version of the Meares-Stamey four-glass localization test was performed and urine specimens were collected for cytological analysis and culture. A postprostatic massage urine sample was used for the urinary PCA3 test.
Four patients had an eventual diagnosis of urethritis and all had a PCA3 score less than 5. Among the remaining 34 patients, 7 had bacterial chronic prostatitis (NIH II prostatitis), 11 had abacterial chronic prostatitis (NIH IIIa), and 16 had non inflammatory prostatodynia (NIH IIIb). All these patients had a PCA3 score less than 28, that is, under the cutoff of 35, which is commonly used for prostate cancer diagnosis. Patients with NIH category IIIa prostatitis had significantly higher number of leukocytes and red cells as well as prostate cells in urine samples but their PCA3 scores did not differ from those of other prostatitis patients.
In this study, NIH II and III chronic prostatitis did not influence the PCA3 score. Our results suggest that increased PCA3 score is unlikely to be explained by the sole chronic prostatitis and warrants prostate biopsies to eliminate prostate cancer.
慢性前列腺炎对血清 PSA 水平的影响众所周知。它是否也会影响前列腺癌(PCa)的潜在新生物标志物尚待确定。我们进行了一项前瞻性研究,以评估慢性前列腺炎对前列腺癌尿标志物 PCA3 的影响。
纳入了 38 名临床疑似慢性前列腺炎的患者,平均年龄为 37.5 岁。进行了简化版的 Meares-Stamey 四杯定位试验,并采集尿液标本进行细胞学分析和培养。前列腺按摩后的尿液样本用于 PCA3 检测。
4 名患者最终诊断为尿道炎,所有患者的 PCA3 评分均低于 5。在其余 34 名患者中,7 名患有细菌性慢性前列腺炎(NIH II 前列腺炎),11 名患有非细菌性慢性前列腺炎(NIH IIIa),16 名患有非炎性前列腺痛(NIH IIIb)。所有这些患者的 PCA3 评分均低于 28,即低于通常用于前列腺癌诊断的 35 分临界值。NIH IIIa 前列腺炎患者的尿液标本中白细胞、红细胞和前列腺细胞数量明显较多,但他们的 PCA3 评分与其他前列腺炎患者没有差异。
在这项研究中,NIH II 和 III 慢性前列腺炎并未影响 PCA3 评分。我们的结果表明,PCA3 评分的增加不太可能仅仅由慢性前列腺炎引起,需要进行前列腺活检以排除前列腺癌。