Clinical Characteristics of Nonmalignant Elevation of Prostate Specific Antigen

Moon, Du Geon; Yoon, Duck Ki

Abstract

PURPOSE: Although prostate specific antigen(PSA) is an excellent tumor marker, it is not prostate cancer-specific but organ-specific. The objectives of this study is to identify the correlation between the nonmalignant elevation of PSA and the characteristics of DRE, TRUS, and histologic features. MATERIALS AND METHOD: Ninety nine patients with elevated PSA were divided into 3 groups of prostatic cancer(46), benign prostatic hyperplasia(46), and infectious prostatic disease(10) according to their clinical history and histology of prostate.
RESULTS
There was significant elevation of PSA in order of prostate cancer, infectious disease, prostatic intraepithelial neoplasia(PIN), and benign prostatic hyperplasia(p > 0.01). Episodes of acute urinary retention and pyuria more frequently induced nonmalignant elevation of PSA(p > 0.05). There was no specific correlation between the findings of TRUS and elevation of PSA except intraprostatic calculi and cyst. Irregularity of margin and seminal vesicle on TRUS highly suggested prostatic cancer. On microscopic examination, high grade PIN, enlarged nucleus, prominent nucleoli and perineural invasion were highly correlated with prostatic cancer.
CONCLUSIONS
These results suggest that nonmalignant elevation of PSA has following clinical characteristics: episodes of urinary retention, bladder calculi, urinary tract infection, prostatic calculi or cyst, and histologically benign. And the values of PSA in nonmalignant condition is not so elevated as malignancy.