Effect of Histological Inflammation on Total and Free Serum Prostate-Specific Antigen Values in Patients Without Clinically Detectable Prostate Cancer

다국어 초록 (Multilingual Abstract)

Purpose: We are often confronted with patients in the “gray zone” (prostate-specific antigen[PSA]＜10 ng/mL) whose biopsies reveal no malignancy but only inflammation.
We investigated the relationship between histological inflammation and total PSA(tPSA), free PSA (fPSA), and percentage of free PSA (f/tPSA) levels in patients withoutprostate cancer (PC).
Materials and Methods: We studied 106 men with tPSA＜10 ng/mL who had undergonebiopsy that was negative for PC and who had no clinical prostatitis. Inflammation observedat biopsies was scored for inflammation type in each biopsy core by use of afour-point scale and was then correlated with tPSA, fPSA, and f/tPSA.
Results: Different patterns of inflammation were found in each set of biopsies.
Regression factor analysis was used to form two groups according to inflammation type:more chronic and more acute. Median tPSA, fPSA, and f/tPSA levels in the more chronicand more acute inflammation groups were 6.4 ng/mL, 1.09 ng/mL, and 15%, and 7.3ng/mL, 0.79 ng/mL, and l2%, respectively. A significant difference was found in fPSA(p=0.003) and f/tPSA (p＜0.001), whereas the difference in tPSA was not significant(p=0.200). Total PSA correlated with fPSA (r=0.4, p＜0.001) but not with inflammationtype (r=0.12, p＞0.010). A correlation existed between inflammation type and fPSA(r=–0.31, p=0.001) and f/tPSA (r=–0.43, p＜0.001) in that the fPSA and f/tPSA were lowerin the group with more acute inflammation.
Conclusions: Subclinical inflammation has a significant influence on fPSA in patientswith tPSA＜10 ng/mL but without PC or clinical prostatitis. Subclinical inflammationis not characterized by elevated tPSA alone but also by a decreased fPSA, a tendencysimilar to that in PC.

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