Korean J Urol.  2011 Jul;52(7):457-460.

Prostate Cancer Can Be Detected Even in Patients with Decreased PSA Less than 2.5 ng/ml after Treatment of Chronic Prostatitis

• Kim YJ
• Kim SO
• Ryu KH
• Hwang IS
• Hwang EC
• Oh KJ
• Jung SI
• Kang TW
• Kwon DD
• Park K
• Ryu SB

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.

Keyword

Biopsy; Prostate-specific antigen; Prostatitis

MeSH Terms

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
Anti-Bacterial Agents
Anti-Inflammatory Agents, Non-Steroidal
Prostate-Specific Antigen

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