Yamamoto M, Hibi H, Miyake K
Department of Urology, Nagoya University School of Medicine.
Hinyokika Kiyo. 1993 May;39(5):445-9.
Prostate-specific antigen (PSA) is now widely accepted as a useful tumor marker for the diagnosis and follow-up of prostatic cancer. An elevated level of PSA has been asserted to be highly specific for prostate cancer, although patients with large benign prostate glands and those with bacterial prostatitis may also have slightly elevated levels. We measured the serum PSA level in the patients with acute and chronic bacterial prostatitis and consecutively monitored the PSA level in 6 patients who had acute prostatitis and an elevated PSA level. The PSA level was found to be elevated during the acute phase of prostatic inflammation, and the elevated, PSA level in the patients with acute prostatitis returned to the normal level within 14 days after initiation of antimicrobial therapy in all 6 patients. In one patient with chronic prostatitis the elevated PSA level persisted after antibiotic treatment. He was found to have adenocarcinoma by transrectal ultrasonography and biopsy. A markedly elevated serum PSA level in bacterial prostatitis can cause confusion in the diagnosis of prostatic carcinoma. Therefore, PSA determination should be obtained after complete clinical resolution of inflammation to exclude prostatic malignant involvement.
前列腺特异性抗原（PSA）现已被广泛公认为是用于前列腺癌诊断和随访的一种有用的肿瘤标志物。尽管前列腺体积较大的良性前列腺增生患者以及细菌性前列腺炎患者的PSA水平也可能略有升高，但PSA水平升高一直被认为对前列腺癌具有高度特异性。我们测定了急性和慢性细菌性前列腺炎患者的血清PSA水平，并连续监测了6例急性前列腺炎且PSA水平升高患者的PSA水平。结果发现，在前列腺炎症急性期PSA水平升高，并且在所有6例患者开始抗菌治疗后的14天内，急性前列腺炎患者升高的PSA水平均恢复至正常水平。在1例慢性前列腺炎患者中，抗生素治疗后PSA升高水平持续存在。经直肠超声检查和活检发现他患有腺癌。细菌性前列腺炎中血清PSA水平明显升高会在前列腺癌的诊断中造成混淆。因此，应在炎症完全临床消退后测定PSA，以排除前列腺恶性病变。
