Langston Marvin E, Pakpahan Ratna, Nevin Remington L, De Marzo Angelo M, Elliott Debra J, Gaydos Charlotte A, Isaacs William B, Nelson William G, Sokoll Lori J, Zenilman Jonathan M, Platz Elizabeth A, Sutcliffe Siobhan
Division of Public Health Sciences, Department of Surgery, Washington University School of Medicine, St. Louis, Missouri.
The Quinism Foundation, White River Junction, Vermont.
Prostate. 2018 Sep;78(13):1024-1034. doi: 10.1002/pros.23660. Epub 2018 May 30.
To extend our previous observation of a short-term rise in prostate-specific antigen (PSA) concentration, a marker of prostate inflammation and cell damage, during and immediately following sexually transmitted and systemic infections, we examined the longer-term influence of these infections, both individually and cumulatively, on PSA over a mean of 10 years of follow-up in young active duty U.S. servicemen.
We measured PSA in serum specimens collected in 1995-7 (baseline) and 2004-6 (follow-up) from 265 men diagnosed with chlamydia (CT), 72 with gonorrhea (GC), 37 with non-chlamydial, non-gonococcal urethritis (NCNGU), 58 with infectious mononucleosis (IM), 91 with other systemic or non-genitourinary infections such as varicella; and 125-258 men with no infectious disease diagnoses in their medical record during follow-up (controls). We examined the influence of these infections on PSA change between baseline and follow-up.
The proportion of men with any increase in PSA (>0 ng/mL) over the 10-year average follow-up was significantly higher in men with histories of sexually transmitted infections (CT, GC, and NCNGU; 67.7% vs 60.8%, P = 0.043), systemic infections (66.7% vs 54.4%, P = 0.047), or any infections (all cases combined; 68.5% vs 54.4%, P = 0.003) in their military medical record compared to controls.
While PSA has been previously shown to rise during acute infection, these findings demonstrate that PSA remains elevated over a longer period. Additionally, the overall infection burden, rather than solely genitourinary-specific infection burden, contributed to these long-term changes, possibly implying a role for the cumulative burden of infections in prostate cancer risk.
为了扩展我们之前的观察结果，即性传播感染和全身感染期间及之后，前列腺特异性抗原（PSA）浓度会短期升高，PSA是前列腺炎症和细胞损伤的标志物，我们在美国年轻现役军人平均10年的随访期间，研究了这些感染单独及累积对PSA的长期影响。
我们测量了1995 - 1997年（基线）和2004 - 2006年（随访）收集的血清样本中的PSA，这些样本来自265名被诊断为衣原体（CT）感染的男性、72名淋病（GC）患者、37名非衣原体、非淋菌性尿道炎（NCNGU）患者、58名传染性单核细胞增多症（IM）患者、91名患有其他全身或非泌尿生殖系统感染（如水痘）的患者；以及125 - 258名在随访期间医疗记录中无传染病诊断的男性（对照组）。我们研究了这些感染对基线和随访之间PSA变化的影响。
在军事医疗记录中有性传播感染史（CT、GC和NCNGU；67.7%对60.8%，P = 0.043）、全身感染史（66.7%对54.4%，P = 0.047）或任何感染史（所有病例合并；68.5%对54.4%，P = 0.003）的男性中，在10年平均随访期间PSA升高（>0 ng/mL）的比例显著高于对照组。
虽然之前已表明PSA在急性感染期间会升高，但这些发现表明PSA在更长时间内仍保持升高。此外，总体感染负担，而非仅泌尿生殖系统特异性感染负担，导致了这些长期变化，这可能意味着感染的累积负担在前列腺癌风险中起作用。
