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.
OBJECTIVE
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.
Karazanashvili
G
G
Urology Service Office, Medical-Diagnostic Centre of Tbilisi State University, Tbilisi, Georgia. guramk@access.sanet.ge
Managadze
L
L
D000368:Aged; D000369:Aged, 80 and over; D000890:Anti-Infective Agents / Q000494:pharmacology* / Q000627:therapeutic use; D006801:Humans; D008297:Male; D008403:Mass Screening / Q000379:methods* / Q000706:statistics & numerical data; D008875:Middle Aged; D015242:Ofloxacin / Q000494:pharmacology* / Q000627:therapeutic use; D010173:Palpation; D011237:Predictive Value of Tests; D017430:Prostate-Specific Antigen / Q000097:blood / Q000187:drug effects*; D011471:Prostatic Neoplasms / Q000097:blood / Q000175:diagnosis* / Q000000981:diagnostic imaging; D011472:Prostatitis / Q000188:drug therapy; D012372:ROC Curve; D012016:Reference Values; D012680:Sensitivity and Specificity; D014463:Ultrasonography
D000890:Anti-Infective Agents; D015242:Ofloxacin; D017430:Prostate-Specific Antigen