Prostate Cancer Can Be Detected Even in Patients with Decreased PSA Less than 2.5 ng/ml after Treatment of Chronic Prostatitis
김영중, 김선옥, 유광호, 황인상, 황의창, 오경진, 정승일, 강택원, 권동득, 박광성, 류수방,
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김영중 ( Kim Young-Jung )
Chonnam National University Medical School Department of Urology
김선옥 ( Kim Sun-Ouck )
Chonnam National University Medical School Department of Urology
유광호 ( Ryu Kwang-Ho )
Chonnam National University Medical School Department of Urology
황인상 ( Hwang In-Sang )
Chonnam National University Medical School Department of Urology
황의창 ( Hwang Eu-Chang )
Chonnam National University Medical School Department of Urology
오경진 ( Oh Kyung-Jin )
Chonnam National University Medical School Department of Urology
정승일 ( Jung Seung-Il )
Chonnam National University Medical School Department of Urology
강택원 ( Kang Taek-Won )
Chonnam National University Medical School Department of Urology
권동득 ( Kwon Dong-Deuk )
Chonnam National University Medical School Department of Urology
박광성 ( Park Kwang-Sung )
Chonnam National University Medical School Department of Urology
류수방 ( Ryu Soo-Bang )
Chonnam National University Medical School Department of Urology
KMID : 0358320110520070457
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.
키워드
Biopsy; Prostate-specific antigen; Prostatitis
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