Clinical significance of urinary white blood cell count and serum C-reactive protein level for detection of non-palpable prostate cancer.
OBJECTIVE
The clinical significance of the urinary white blood cell (U-WBC) count and serum C-reactive protein (CRP) level was evaluated in an effort to improve the efficiency of prostate biopsies.


METHODS
We enrolled 228 consecutive patients with serum prostate-specific antigen (PSA) ranging from 3.0 to 20.0 ng/mL, normal digital rectal examination findings, and who underwent prostate biopsies between January 2001 and August 2004. Of these, 157 patients had histologically confirmed benign prostatic disease and the remaining 71 patients had prostate cancer. Patients with a pretreatment U-WBC count < or =3 or >3/high power field were defined as non-pyuria and pyuria, respectively. The patients were also separated into two groups based on the serum CRP level prior to biopsy. Several clinical factors were compared among these subgroups.


RESULTS
Inflammation was histologically detected at rates of 58.1% and 34.1% in the pyuria and non-pyuria groups, respectively (P = 0.0014). The rates of cancer detection were significantly lower in the pyuria, than in the non-pyuria group (P = 0.0384). The cancer detection rates did not significantly differ according to serum CRP levels prior to biopsy.


CONCLUSIONS
The U-WBC count appears to be a reliable indicator of minute prostatic inflammation. The serum PSA level was elevated in patients with asymptomatic prostatitis. Counting U-WBC is a simple, convenient and non-invasive method that should be valuable part of routine urological examinations.
Kato
Tomonori
T
Department of Urology, Chiba University, Graduate School of Medicine, Japan.
Suzuki
Hiroyoshi
H
Komiya
Akira
A
Imamoto
Takashi
T
Naya
Yukio
Y
Tobe
Toyofusa
T
Ichikawa
Tomohiko
T
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D014408:Biomarkers, Tumor / Q000097:blood*; D001706:Biopsy / Q000379:methods; D002097:C-Reactive Protein / Q000378:metabolism*; D003937:Diagnosis, Differential; D019160:Endosonography; D005500:Follow-Up Studies; D006801:Humans; D007958:Leukocyte Count; D008297:Male; D008875:Middle Aged; D010173:Palpation; D011379:Prognosis; D017430:Prostate-Specific Antigen / Q000097:blood; D011471:Prostatic Neoplasms / Q000097:blood / Q000175:diagnosis / Q000652:urine; D012189:Retrospective Studies; D014556:Urine / Q000166:cytology*
D014408:Biomarkers, Tumor; D002097:C-Reactive Protein; D017430:Prostate-Specific Antigen