2065 INVERSE ASSOCIATION BETWEEN THE PRESENCE OF HISTOLOGICAL INFLAMMATION IN NEEDLE BIOPSY SPECIMENS AND THE POSITIVE BIOPSY FINDINGS FOR PROSTATE CANCER IN MEN WITH SERUM PROSTATE-SPECIFIC ANTIGEN LEVEL OF 10 - 50 NG/ML

Abstract

You have accessJournal of UrologyProstate Cancer: Detection and Screening IV1 Apr 20122065 INVERSE ASSOCIATION BETWEEN THE PRESENCE OF HISTOLOGICAL INFLAMMATION IN NEEDLE BIOPSY SPECIMENS AND THE POSITIVE BIOPSY FINDINGS FOR PROSTATE CANCER IN MEN WITH SERUM PROSTATE-SPECIFIC ANTIGEN LEVEL OF 10 - 50 NG/ML Tomoaki Terakawa, Hideaki Miyake, Iori Sakai, and Masato Fujisawa Tomoaki TerakawaTomoaki Terakawa Akashi, Japan More articles by this author , Hideaki MiyakeHideaki Miyake Kobe, Japan More articles by this author , Iori SakaiIori Sakai Kobe, Japan More articles by this author , and Masato FujisawaMasato Fujisawa Kobe, Japan More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2012.02.2230AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES The utility of prostate-specific antigen (PSA) is occasionally lessened by an abnormal elevation under several unusual conditions, including inflammatory changes of the prostate. Although acute bacterial prostatitis results in the remarkable elevation of serum PSA, the effect of asymptomatic inflammation within the prostate on serum PSA level has not been well characterized. The objective of this study was to analyze the impact of the presence of histologically inflammation in needle biopsy specimens on the detection of prostate cancer in men with comparatively high serum PSA level. METHODS This study included 286 consecutive patients with serum PSA ranging from 10 - 50 ng/ml who initially underwent transrectal systematic biopsy of the prostate. A single pathologist reviewed all the biopsy specimens, and moderate or severe inflammation in the biopsy specimens according to the report by De Marzo (Am J Pathol 1999; 155: 1985-1992) was defined as the presence of histological inflammation. RESULTS In this series, 172 patients (60.1%, Group A) were diagnosed as having prostate cancer, and the remaining 114 (39.9%, Group B) were negative for malignant lesion in the biopsy specimens. There was a significant difference in the incidence of histological inflammation between the Group A (40.7%) and the Group B (73.7%). Prostate volume, transition zone (TZ) volume and the incidence of histological inflammation in Group A was significantly smaller than those in Group B, while PSA density and PSA density of the TZ in Group A were significantly greater than those in Group B. Univariate analysis identified prostate volume, TZ volume, PSA density, PSA density of the TZ and histological inflammation as significant predictors of prostate cancer, among which only PSA density and histological inflammation were appeared to be independently associated with the detection of prostate cancer on multivariate analysis. Furthermore, combined consideration of these two independent factors could differentiate prostate cancer from benign disease in the biopsy specimens with 87.2% sensitivity, 63.2% specificity, 78.1% positive predictive value and 76.6% negative predictive value. CONCLUSIONS These findings suggest that it would be possible to avoid unnecessary repeat biopsy using PSA density and the presence of histological inflammation in biopsy specimens in patients with continuously elevated serum PSA after initial biopsy. © 2012 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 187Issue 4SApril 2012Page: e833 Advertisement Copyright & Permissions© 2012 by American Urological Association Education and Research, Inc.MetricsAuthor Information Tomoaki Terakawa Akashi, Japan More articles by this author Hideaki Miyake Kobe, Japan More articles by this author Iori Sakai Kobe, Japan More articles by this author Masato Fujisawa Kobe, Japan More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...