Extent of prostatic atrophy in needle biopsies and serum PSA levels: is there an association?
OBJECTIVE
Prostatic atrophy is one of the most frequent benign mimics of prostate adenocarcinoma. Regardless of the cause, we hypothesized that damaged epithelial cells in the atrophic acini could be a source of the elevation of serum prostate-specific antigen (PSA). The aim of this study was to find any possible association between the extent of prostatic atrophy in needle biopsies and serum PSA level.


METHODS
The study was based on 131 needle prostatic biopsies corresponding to 107 patients. The only diagnosis in all biopsies was focal prostatic atrophy without the presence of cancer, high-grade prostatic intraepithelial neoplasia, or areas suspicious for cancer. The extent of atrophy was measured in two ways: the linear extent in millimeters and the percentage of linear extent showing atrophy for each biopsy. Spearman's coefficient of rank correlation was used to evaluate the association of atrophy extent with total and free serum PSA levels.


RESULTS
A positive and statistically significant correlation was found between the linear atrophy extent and the total serum PSA level (r = 0.25, P = <0.01) and free PSA level (r = 0.23, P = 0.01). A positive and statistically significant correlation was found between the percentage of the linear extent showing atrophy and the total serum PSA level (r = 0.23, P = 0.01) and free PSA level (r = 0.20, P = 0.02).


CONCLUSIONS
A positive and significant association was found between the extent of atrophy and the total or free serum PSA elevation. The findings suggest that damaged epithelial cells in atrophic acini, regardless of cause, could be a source of serum PSA elevation.
Billis
Athanase
A
Department of Anatomic Pathology, State University of Campinas School of Medicine, Campinas, São Paulo, Brazil. athanase@fcm.unicamp.br
Meirelles
Luciana R
LR
Magna
Luis A
LA
Baracat
Jamal
J
Prando
Adilson
A
Ferreira
Ubirajara
U
D000230:Adenocarcinoma / Q000175:diagnosis / Q000473:pathology*; D000368:Aged; D000369:Aged, 80 and over; D001284:Atrophy / Q000473:pathology; D001707:Biopsy, Needle; D015331:Cohort Studies; D003937:Diagnosis, Differential; D006801:Humans; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D011336:Probability; D017430:Prostate-Specific Antigen / Q000032:analysis*; D011471:Prostatic Neoplasms / Q000175:diagnosis / Q000473:pathology*; D011472:Prostatitis / Q000175:diagnosis / Q000473:pathology*; D012307:Risk Factors; D012680:Sensitivity and Specificity; D012720:Severity of Illness Index
D017430:Prostate-Specific Antigen