Prostate-specific antigen test in diagnostic evaluation of chronic prostatitis/chronic pelvic pain syndrome.
OBJECTIVE
To determine whether prostate-specific antigen (PSA), the percent free PSA, or free PSA isoforms may be used as diagnostic markers for chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS; National Institutes of Health category IIIa and IIIb).


METHODS
We evaluated 421 patients enrolled in the Chronic Prostatitis Cohort Study and 112 age-matched controls. Subjects were stratified by the number of white blood cells (WBCs) in their expressed prostatic secretions and pain as determined by the National Institutes of Health Chronic Prostatitis Symptom Index.


RESULTS
Total PSA, free PSA, and [-2]proPSA ([-2]pPSA) were significantly elevated in those with CP/CPPS compared with controls (mean PSA 1.97 ng/mL versus 1.72 ng/mL, P = 0.03; mean free PSA 0.76 ng/mL versus 0.70 ng/mL, P = 0.01; and [-2]pPSA 2.38 ng/mL versus 1.80 ng/mL, P = 0.04). The percent free PSA was not significantly different between the patients and controls. For those with CP/CPPS, the percent free PSA was significantly lower as the WBC count rose in the expressed prostatic secretions (0 WBCs = 43.29 versus more than 25 WBCs = 26.52; P < .0001). A PSA level of 4.0 ng/mL or greater was found in 10% of patients and 7% of controls (P = 0.03).


CONCLUSIONS
Men with elevated PSA values and CP/CPPS should be treated as one would any other patient screened for prostate cancer with an elevated PSA level. Although PSA, free PSA, and [-2]pPSA were slightly elevated in men with CP/CPPS, the low sensitivity and specificity do not warrant using them as biomarkers for CP/CPPS.
Nadler
Robert B
RB
Department of Urology, Northwestern University Feinberg School of Medicine, Chicago, Illinois 60611, USA. r-nadler@northwestern.edu
Collins
Mary McNaughton
MM
Propert
Kathleen J
KJ
Mikolajczyk
Stephen D
SD
Knauss
Jill S
JS
Landis
J Richard
JR
Fowler
Jackson E
JE
Schaeffer
Anthony J
AJ
Alexander
Richard B
RB
D015415:Biomarkers / Q000097:blood; D002908:Chronic Disease; D006801:Humans; D008297:Male; D017699:Pelvic Pain / Q000097:blood*; D017430:Prostate-Specific Antigen / Q000097:blood*; D011472:Prostatitis / Q000097:blood*; D013577:Syndrome
D015415:Biomarkers; D017430:Prostate-Specific Antigen