Effect of Inflammation and Benign Prostatic Hyperplasia on Elevated Serum Prostate Specific Antigen Levels

Abstract

No AccessJournal of UrologyClinical Urology: Original Article1 Aug 1995Effect of Inflammation and Benign Prostatic Hyperplasia on Elevated Serum Prostate Specific Antigen Levels Robert B. Nadler, Peter A. Humphrey, Deborah S. Smith, William J. Catalona, and Timothy L.* Ratliff Robert B. NadlerRobert B. Nadler , Peter A. HumphreyPeter A. Humphrey , Deborah S. SmithDeborah S. Smith , William J. CatalonaWilliam J. Catalona , and Timothy L.* RatliffTimothy L.* Ratliff View All Author Informationhttps://doi.org/10.1016/S0022-5347(01)67064-2AboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract Purpose: We quantify the causes of elevated serum prostate specific antigen (PSA) concentrations in men whose prostate biopsies repeatedly showed no cancer. Materials and Methods: The effects of prostate volume, inflammation, echogenicity on ultrasound and calculi were examined in a large PSA-based screening population of 148 men with serum PSA concentrations greater than 4.0 ng./ml., findings suspicious for cancer on digital rectal examination and multiple negative biopsies. These men were selected and compared to 64 men with suspicious rectal examinations, multiple negative biopsies and serum PSA concentrations of 4.0 ng./ml. or less. Results: The high PSA group had larger prostates (68 versus 33 cc, p = 0.0001) and significantly more subclinical prostatic inflammation. Acute and chronic inflammation was more prevalent in the high PSA group (63 percent versus 27 percent, p = 0.0001 and 99 percent versus 77 percent, p = 0.0001, respectively). A simultaneous regression analysis showed that prostatic size accounted for 23 percent, inflammation 7 percent, prostatic calculi 3 percent and nonisoechoic ultrasound lesions 1 percent of the serum PSA variance. Conclusions: Prostate volume and inflammation are the most important factors contributing to serum PSA elevation in men without clinically detectable prostate cancer. References 1 : Prostate-specific antigen as a serum marker for adenocarcinoma of the prostate. New Engl. J. Med.1987; 317: 909. Google Scholar 2 : Measurement of prostate-specific antigen in serum as a screening test for prostate cancer. New Engl. J. Med.1991; 324: 1156. Google Scholar 3 : Detection of organ-confined prostate cancer is increased through prostate-specific antigen-based screening. J.A.M.A.1993; 270: 948. Google Scholar 4 : Clinical use of prostate specific antigen in patients with prostate cancer. J. Urol.1989; 142: 1011. 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Volume 154Issue 2August 1995Page: 407-413 Advertisement Copyright & Permissions© 1995 by American Urological Association, Inc.MetricsAuthor Information Robert B. Nadler More articles by this author Peter A. Humphrey More articles by this author Deborah S. Smith More articles by this author William J. Catalona More articles by this author Timothy L.* Ratliff More articles by this author Expand All Advertisement PDF DownloadLoading ...