Inflammation in prostate biopsies of men without prostatic malignancy or clinical prostatitis - Correlation with total serum PSA and PSA density
Inflammation in prostate biopsies of men without prostatic malignancy or clinical prostatitis - Correlation with total serum PSA and PSA density
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DOI：
10.1159/000020161
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发表时间：
2000-04-01
期刊：
影响因子：
23.4
通讯作者：
Van Marck, E
中科院分区：
文献类型：
--
作者：
Schatteman, PHF;Hoekx, L;Van Marck, E
目的：炎症是前列腺活检中常见的组织学发现，对没有前列腺恶性肿瘤或临床前列腺炎的男性进行。我们研究了前列腺组织炎症的形态学参数和总血清前列腺特异性抗原（PSA）和前列腺特异性抗原密度（PSAD）水平之间的关系，以确定亚临床炎症是否会导致PSA和PSAD.Methods升高：我们回顾了268例前列腺活检，238例男性PSA升高和/或前列腺直肠指检异常。所有癌前病变和恶性活检和临床前列腺炎病例均被排除。使用Irani及其同事设计的四点量表，对其余145例前列腺活检中的炎症进行炎症程度和炎症侵袭性评分。在该前列腺炎症评分系统中，根据前列腺组织中炎性细胞的侵袭程度，炎症程度从0到3分级。根据前列腺上皮接触或破坏的程度，炎症的侵袭性从0到3分级炎症cytes.Results：每一个研究的活检显示炎性细胞。炎症程度1级、2级和3级的中位PSA水平分别为5.7、6.8和13.0。这些组的中位PSAD水平分别为0.13、0.16和0.33。PSA和PSAD的这些等级之间无显著差异。炎症侵袭性0级、1级和2级的中位PSA水平分别为3.9、5.9和8.9。这些组的中位PSAD水平分别为0.12、0.18和0.17。对于这两个参数，有一个显着差异等级（分别为p = 0.0028和p = 0.0330）。结论：前列腺炎症是一个组织学发现，几乎每一组前列腺活检，即使没有临床前列腺炎的迹象。这种亚临床炎症可导致PSA升高。重要的不是炎症的程度，而是由炎症浸润引起的上皮完整性的破坏。当遇到PSA水平升高的患者，其前列腺活检显示没有恶性肿瘤，只有炎症时，这个概念可以帮助确定是否需要快速重复活检。版权所有（C）2000 S. Karger AG，巴塞尔。
Objective: Inflammation is a frequent histological finding in prostate biopsies, performed on men without prostatic malignancy or clinical prostatitis. We investigated the relationship between morphological parameters of inflammation in prostatic tissue and total serum prostate-specific antigen (PSA) and prostate-specific antigen density (PSAD) levels to determine if subclinical inflammation can cause elevation of PSA and PSAD.Methods: We reviewed 268 prostate biopsies, performed on 238 men with elevated PSA and/or abnormal digital rectal examination of the prostate. All premalignant and malignant biopsies and cases of clinical prostatitis were excluded. The inflammation in the remaining 145 prostate biopsies was scored for extent of inflammation and aggressiveness of inflammation, using the four-point scale designed by Irani and co-workers. In this prostatic inflammation scoring system, extent of inflammation is graded from 0 up to 3 according to the degree of invasion of inflammatory cells in prostatic tissue. Aggressiveness of inflammation is graded from 0 up to 3 according to the degree of contact or disruption of prostatic glandular epithelium by inflammatory cells.Results: Each of the studied biopsies showed inflammatory cells. Median PSA levels in grades 1, 2 and 3 of extent of inflammation were, respectively, 5.7, 6.8 and 13.0. Median PSAD levels in these groups were 0.13, 0.16 and 0.33. There was no significant difference between these grades for PSA nor for PSAD. Median PSA levels in grades 0, 1 and 2 of aggressiveness of inflammation were, respectively, 3.9, 5.9 and 8.9. Median PSAD levels in these groups were 0.12, 0.18 and 0.17. For both parameters, there was a significant difference between grades (respectively, p = 0.0028 and p = 0.0330).Conclusion: Inflammation of the prostate is a histological finding in almost every set of prostate biopsies, even when there are no signs of clinical prostatitis. This subclinical inflammation can cause PSA elevation. Not the extent of inflammation is of importance, but the disruption of epithelial integrity caused by the inflammatory infiltrate. When confronted with a patient with an elevated PSA level whose prostate biopsies reveal no malignancy but only inflammation, this concept can help in determining the need for quick repeat biopsies. Copyright (C) 2000 S. Karger AG, Basel.