Prostate Cancer Can Be Detected Even in Patients with Decreased PSA Less than 2.5 ng/ml after Treatment of Chronic Prostatitis.
10.4111/kju.2011.52.7.457
- Author:
Young Jung KIM
1
;
Sun Ouck KIM
;
Kwang Ho RYU
;
In Sang HWANG
;
Eu Chang HWANG
;
Kyung Jin OH
;
Seung Il JUNG
;
Taek Won KANG
;
Dong Deuk KWON
;
Kwangsung PARK
;
Soo Bang RYU
Author Information
1. Department of Urology, Chonnam National University Medical School, Gwangju, Korea. seinsena@hanmail.net
- Publication Type:Original Article
- Keywords:
Biopsy;
Prostate-specific antigen;
Prostatitis
- MeSH:
Anti-Bacterial Agents;
Anti-Inflammatory Agents, Non-Steroidal;
Biopsy;
Follow-Up Studies;
Humans;
Inflammation;
Leukocytes;
Male;
Prospective Studies;
Prostate;
Prostate-Specific Antigen;
Prostatic Hyperplasia;
Prostatic Neoplasms;
Prostatitis
- From:Korean Journal of Urology
2011;52(7):457-460
- CountryRepublic of Korea
- Language:English
-
Abstract:
PURPOSE: We evaluated men with documented chronic prostatitis and elevated serum prostate-specific antigen (PSA) to determine whether treatment with antibiotics and anti-inflammatory drugs can lower serum PSA and the cancer detection rate in patients with post-treatment PSA <4 ng/ml. MATERIALS AND METHODS: Eighty-six men who presented with serum PSA greater than 4 ng/ml and who were subsequently diagnosed with chronic prostatitis with greater than 10 white blood cells per high power field in expressed prostatic excretions were included in this prospective study. Patients meeting these criteria underwent treatment with a 4-week course of antibiotics and nonsteroidal anti-inflammatory agents. Follow-up PSA and transrectal ultrasonography-guided prostate biopsy were performed within 2 months of treatment for all patients. RESULTS: Mean patient age was 56.2 years (range, 37-72 years). Mean PSA (ng/ml) decreased by 33.8%, from 8.12 (range, 4.02-24.8) to 5.37 (range, 1.35-12.94), after treatment (p=0.001). Pathological studies revealed prostate cancer in 18 cases (20.9%), chronic inflammation in 64 (74.4%), and benign prostatic hypertrophy in 4 (4.7%). The prostate cancer detection rate according to the follow-up PSA level, below 2.5, from 2.5 to 4.0, and above 4.0, was 13.3% (2/15), 13.6% (3/22), and 26.5% (13/49), respectively. CONCLUSIONS: When chronic prostatitis with elevated PSA is identified, antibiotic and anti-inflammatory treatment can lower these PSA levels. However, the possibility of prostate cancer remains in patients whose PSA level decreases to less than 4 ng/ml, even in those with a PSA level less than 2.5 ng/ml.
