title: Increased prostate-specific antigen in subclinical prostatitis: the role of aggressiveness and extension of inflammation.
abstract: OBJECTIVE
  Subclinical prostatitis is a very frequent histologic finding in pathological examinations of prostate biopsy and prostate surgery material. In this study, we tried to investigate the correlation between the morphological parameters of histological prostatitis and total serum prostate-specific antigen (PSA)-PSA density (PSAD) to determine if either the extent or aggressiveness of inflammation might affect serum PSA.
  
  
  METHODS
  269 patients who had undergone TURP or transvesical prostatectomy with pathological diagnosis of BPH and prostatitis were included in the study. We retrospectively reviewed and scored the extent and aggressiveness of inflammation in prostate specimens of BPH, according to the scale that has been reported by Irani et al. and then correlated those scores with PSA and PSAD.
  
  
  RESULTS
  When the inflammation grades correlated with PSA and PSAD, the extent of the inflammation did not show a significant correlation with total PSA and PSAD (p > 0.05). However, there was a statistically significant correlation between aggressiveness grades and total PSA and PSAD (p < 0.001). Median PSA levels in grades 0, 1 and 2 of aggressiveness of inflammation were 3.2, 4.2 and 5.8 respectively.
  
  
  CONCLUSIONS
  Aggressiveness grade of the inflammation in subclinical prostatitis is the most important morphological factor that is responsible for PSA elevation. We believe that it should be a more accurate guide for the clinician if pathologists report on the aggressiveness grades of the inflammation, especially on initial prostate biopsies, in order to help for timing of the further biopsy.
authors.affiliation: Department of Urology, Ankara University, School of Medicine, Ankara, Turkey.
authors.forename: Onder
authors.initials: O
authors.lastname: Yaman
authors.forename: Cağatay
authors.initials: C
authors.lastname: Göğüş
authors.forename: Ozden
authors.initials: O
authors.lastname: Tulunay
authors.forename: Zafer
authors.initials: Z
authors.lastname: Tokatli
authors.forename: Eriz
authors.initials: E
authors.lastname: Ozden
mesh_terms: D000368:Aged; D006801:Humans; D008297:Male; D011467:Prostate / Q000473:pathology*; D017430:Prostate-Specific Antigen / Q000097:blood*; D011468:Prostatectomy; D011470:Prostatic Hyperplasia / Q000473:pathology / Q000601:surgery; D011472:Prostatitis / Q000473:pathology* / Q000601:surgery; D012189:Retrospective Studies
chemical_list: D017430:Prostate-Specific Antigen