The correlation of extent and grade of inflammation with serum PSA levels in patients with IV prostatitis

Abstract

Objectives: The inflammation was categorized more profoundly, using the standardized histopathological classification system for chronic prostatitis of NIH, to determine the influence of prostatic inflammation on serum PSA levels.

Methods: The study included 120 patients who underwent transperineal ultrasound-guided prostate biopsy. The patients were divided into groups using 3 grades for the extent, the location and the aggressiveness of prostate inflammation. The serum tPSA levels, fPSA levels, %fPSA, and PSAD in each group were compared.

Results: Of 120 patients, 80 with benign prostatic tissue in their biopsy specimens met the inclusion criteria, excluding 40 cases with prostate cancer. The inflammation was present in 46(57.5%) of 80 cases. The extent of inflammation correlated positively with the total PSA level (r = 0.6, P < 0.001), fPSA (r = 0.5, P = 0.001) and PSAD (r = 0.6, P < 0.001). The grade of inflammation correlated positively with the total PSA level (r = 0.5, P < 0.001), fPSA (r = 0.4, P = 0.008) and PSAD (r = 0.7, P < 0.001). A negative correlation was found between the grade of inflammation and %fPSA (r = -0.4, P = 0.013).

Conclusions: If the elevation of serum PSA is thought to be caused by asymptomatic prostatitis with high aggressiveness score in BPH patients without clinical prostatitis, it might prevent unnecessary repeated biopsies.