Age-specific Reference Range of Prostate-specific Antigen in Healthy Men Received Multipathic Health Checkup Center / 대한비뇨기과학회지

PURPOSE: This study is to determine age-specific reference range of serum concentration of prostate-specific antigen(PSA) in each decades of age for whom PSA levels were checked in our Multipathic Health Checkup Center. MATERIALS AND METHODS: Between February 1996 and August 1998, the serum PSA of 10,691 men aged 20 to 79 years were checked from Multipathic Health Checkup Center. All cases of lower urinary tract infection(>4WBC/HPF in urinalysis) were excluded from the analysis. PSA was measured by Enzyme Immuno-Assay(AxSYM kit, Abbott Co.) techniques. Patients were grouped according to age by decade: group 20`s(n=941), group 30`s(n=3,963), group 40`s(n=3,607), group 50`s(n=1,735), group 60`s(n=392) and group 70`s(n=53). RESULTS: Based on linear regression analysis, serum PSA concentration was correlated with patient age significantly(r=0.091, p<0.005). The mean PSA values(ng/ml) of each age groups were 20`s: 0.927+/-.660, 30`s: 0.931+/-.664, 40`s: 0.951+/-.715, 50`s: 1.035+/-.883, 60`s: 1.369+/-.607 and 70`s: 2.244+/-.317. The upper limits of PSA(mean+2SD) according to age were 20`s: 2.25ng/ml, 30`s: 2.26ng/ml, 40`s: 2.38ng/ml, 50`s: 2.80ng/ml, 60`s: 4.58ng/ml and 70`s: 8.88ng/ml. CONCLUSIONS: These findings confirmed earlier observations that serum PSA were age-dependent and age-specific, and it were lower for Korean men than for white men. The age-specific reference ranges for Korean men should be established, and then the PSA assay could become more efficient as a screening test for prostatic cancer.

A Case of Mucinous Adenocarcinoma of Urinary Bladder Type Arising from the Prostatic Urethra / 대한비뇨기과학회지

We describe a case of mucinous adenocarcinoma which originated from the prostatic urethra, extended to right ischiorectal fossa and the seminal vesicles, and metastasized to bone. This case was identical to adenocarcinoma arising from the urinary bladder and differed from mucinous adenocarcinoma of the prostate. This tumor was negative immunohistochemically for prostate-specific antigen and prostate-specific acid phosphatase and positive for carcinoembryo -nic antigen. In terms of therapy, the distinction between mucinous adenocarcinoma of urinary bladder-type arising from the prostatic urethra and mucinous adenocarcinoma of the prostate is significant.

Chronic Prostatitis and Urethritis / 대한남성과학회지

PURPOSE: It is generally believed that chronic prostatitis is initiated by urethritis. However in actual clinical situations, many male patients without histories of urethritis present with prostatitis. To evaluate the possible relationship, we reviewed of patients with chronic prostatitis. MATERIALS AND METHODS: 326 consecutive patients with prostatitis were reviewed retrospectively on: duration of prostatitis, any history of urethritis, and history of intercourse including incidents with a high risk partner (eg. prostitutes). Prostatic ultrasonographic findings and voiding symptoms were compared with history of urethritis. RESULTS: A history of urethritis was found in 228 (70%) of patients, but 36 (11%) denied both sexual intercourse and urethritis. In 62 (19%) patients, there was no history of urethritis but there existed a sexual encounter with a high risk partner. There is no statistically difference between the history of urethritis and the duration of prostatitis, the prostatic ultrasonographic findings, and voiding symptoms. Therefore no significant relationship between urethritis and chronic prostatitis was found. CONCLUSIONS: These data suggest that having urethritis is not an important risk factor in chronic prostatitis. These studies may be comforting to those who are inflicted with chronic prostatitis and concerned with the nature of the disease. Thus chronic prostatitis can be explained as an inflammation of the prostate, not a dreadful end result of sexually transmitted disease.

PSA and Prostatitis in Men under 45 Years Old / 대한비뇨기과학회지

PURPOSE: We evaluated the effect of prostatitis on prostatic-specific antigen(PSA) in 79 patients aged under 45 years old complained symptoms of prostatism. MATERIALS AND METHOD: The patients were divided into 2 groups: 61 patients who were diagnosed with prostatitis(group P) and 18 patients with prostatodynia and a history of prostatitis(group PD). As a control(group N) the PSA data obtained in the serial screening program of primary health clinic of 3,992 men under 45 years old were used. PSA was measured by Enzyme Immuno-Assay (AxSYM kit, Abbott Co.) and Tandem-R techniques. Prostate size was measured by the ellipsoidal method using the transrectal ultrasonogram (SonoAce 5000, Medison, Korea). RESULTS: Mean age was 37 years old for both control and patients(Group p,36; Group PD, 39; Group N, 37). Average serum PSA level(ng/ml) was 2.00(Group p, 1.99; Group PD, 2.05; Group N, 0.97). When PSA level was correlated with different age groups (20's; 30's; 40-45), PSA levels were 1.04, 0.96, and 0.96ng/m1 for group N and 1.77, 2.00, and 2.17ng/m1 for groups P & PD, which was significantly higher than group N(p<0.05). The numbers of patients with PSA above 4.0ng/ml were more frequently seen in group P & PD than N(group P & PD 11%, group N 0.88%). The average prostatic volume was 20.9cc (Group p,20.2; Group PD,23.3). The prostatic volume was significantly larger in Group PO but no significant correlations were noted between PSA and PSAD and between PSA and EPS WBC count. There were 19 patients in the first decade,30 in the second decade and 40 between 41-45 years and the average PSA levels were 1.77, 2.00, and 2.17ng/m1, respectively. Average prostate volumes were 18.6, 19.9, and 23.4cc, and the average PSAD 0.10, 0.10, 0.09, respectively; no significant correlation was seen in any of the measurements between the three age groups. Conclusions: These findings indicate that serum PSA level can be elevated in prostatitis and careful consideration be made when PSA is used as a tumor marker.