Prostate–Specific Antigen (PSA) Value Change after Antibacterial Therapy of Prostate Inflammation, as a Diagnostic Method for Prostate Cancer Screening in Cases of PSA Value within 4–10 ng/ml and Nonsuspicious Results of Digital Rectal Examination

Abstract

Objectives: Investigation of the possibilities of improving the accuracy of prostate cancer (PC) screening among patients with a PSA value of 4–10 ng/ml and nonsuspicious results of digital rectal examination (DRE), using as diagnostic method the PSA value change (PSA–VCh) after antibacterial treatment of prostate inflammation. Methods: The study included 61 patients with PSA 4–10 ng/ml, nonsuspicious DRE and inflammation in expressed prostate secretion (EPS). All these patients underwent antibacterial therapy with the following repeated PSA determination and PSA–VCh assessment. Results: Antibacterial therapy led to PSA decrease in 80% of cases. Effectiveness of PSA–VCh in PC screening was estimated. Sensitivity of PSA–VCh (with cut–off point –0.1·100%) equaled 85%, specificity 96%, positive predictive value 85% and negative predictive value 96%. Conclusions: Prostate inflammation proves to be a significant factor contributing to serum PSA elevation up to 10 ng/ml among patients with nonsuspicious DRE. Assessment of PSA–VCh after antibacterial treatment can improve PC screening accuracy in cases of PSA 4–10 ng/ml, nonsuspicious DRE and inflammation in EPS.