A study of histopathological factors increasing postage-specific antigen / 中华泌尿外科杂志

ABSTRACT

Objective To evaluate the cause of evaluated postage-specific antigen(PSA)in patients performed transrectal uhrasonography(TRUSG)guided prostate biopsy beeause of high PSA levels.Methods In a retrospective study 504 prostate biopsies performed between January 1998 and December 2001 were evaluated and the levels of serum PSA were determined in samples obtained immediately before sextant biopsy was performed.All patients underwent 6 or 13 cote primary prostate needle biopsies.Results 185 prostate cancer,109 NIH-Ⅳ prostatitis and 210 patients with benign prostate hyperplasia(BPH)were identified.The difference in free-PSA,total-PSA,f/t-PSA levels between prostate cancer,BPH and NIH-Ⅳ prostatitis was significant(P＜0.05).No significant difference was found in age,transrectal ultrasonography and digital rectal examination.In multivariate analysis,free-PSA,total-PSA,f/t-PSA was the significant predictors of histology in prostate cancer(P＜0.05).A significant correlation was found between the serum total and free PSA levels and the grade and stage of prostate cancer(P＜0.05).Preoperative variables predictors of histology in BPH were TPSA and FPSA(P＜0.05).In multivariate analysis,TPSA was the only significant predictors of histology in BPH(P＜0.01).The best cutoff value was constructed to differ pathology type in prostate diseasestPSA≥4 ng/ml,fPSA≥0.85 ng/ml and f/t-PSA≤0.16(P＜0.05).Conclusions High serum PSA levels may correlate with asymptomatic inflammatory prostatitis,prostate cancer and BPH.The factors contributing to elevated serum PSA concentrations include cell proliferating,glandular epithelial disrupt.