title: Association of extent and aggressiveness of inflammation with serum PSA levels and PSA density in asymptomatic patients.
abstract: OBJECTIVE
  The relationship between serum prostate-specific antigen (PSA) levels and histologic prostatic inflammation is controversial. Previous studies were performed using either the intensity or extent of inflammation for grading, with a relatively lower number of specimens. In our study, the inflammation was categorized more profoundly, using both the intensity and the extent of inflammation, to determine the influence of prostatic inflammation on serum PSA levels, percent free PSA (%fPSA), and PSA density (PSAD).
  
  
  METHODS
  The study included 115 patients who underwent transrectal ultrasound-guided prostate biopsy. To categorize the inflammation, a grading method that included the intensity and extent of inflammation was used. The extent and aggressiveness of inflammation were analyzed. The patients were divided into groups using five grades for the extent and four grades for the aggressiveness of inflammation. The serum PSA levels, fPSA levels, %fPSA, and PSAD in each group were compared.
  
  
  RESULTS
  The extent of inflammation grade correlated positively with the serum PSA level (r = 0.423, P <0.001) and PSAD (r = 0.319, P = 0.001). However, a negative correlation was found between the extent of inflammation grade and %fPSA (r = -0.268, P = 0.015). The aggressiveness of inflammation grade correlated positively with the serum PSA level (r = 0.386, P <0.001) and PSAD (r = 0.341, P = 0.001) and negatively with %fPSA (r = -0.289, P = 0.03).
  
  
  CONCLUSIONS
  If the elevation of serum PSA is thought to be caused by histologic inflammation, it might prevent unnecessary repeated biopsies.
authors.affiliation: Department of Urology, Abant Izzet Baysal University, Izzet Baysal Medical Faculty, Bolu, Turkey. ekandirali@yahoo.com
authors.forename: Engin
authors.initials: E
authors.lastname: Kandirali
authors.forename: Cetin
authors.initials: C
authors.lastname: Boran
authors.forename: Erdinc
authors.initials: E
authors.lastname: Serin
authors.forename: Atilla
authors.initials: A
authors.lastname: Semercioz
authors.forename: Ahmet
authors.initials: A
authors.lastname: Metin
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001707:Biopsy, Needle; D006801:Humans; D007249:Inflammation; D008297:Male; D008875:Middle Aged; D011467:Prostate / Q000473:pathology; D017430:Prostate-Specific Antigen / Q000097:blood*; D011472:Prostatitis / Q000097:blood / Q000175:diagnosis / Q000473:pathology*
chemical_list: D017430:Prostate-Specific Antigen