Inverse association between histologic inflammation in needle biopsy specimens and prostate cancer in men with serum PSA of 10-50 ng/mL.
OBJECTIVE
To investigate the effect of the presence of histologic inflammation in needle biopsy specimens on the detection of prostate cancer (PCa) in men with a high serum prostate-specific antigen (PSA) level.


METHODS
This study included 143 consecutive patients with serum a PSA level of 10-50 ng/mL who had undergone initial needle biopsies of the prostate. We defined moderate or severe inflammation in the biopsy specimens, according to De Marzo et al., as the presence of histologic inflammation.


RESULTS
Of the 143 patients, 86 and 57 were diagnosed with PCa (PCa group) or benign prostatic disease (BPD group), respectively. The prostate volume and transition zone volume in the PCa group were significantly smaller than those in the BPD group, and the serum PSA level, PSA density (PSAD), and PSAD in the transition zone were significantly greater than those in the BPD group. A significant difference was found in the incidence of histologic inflammation between the PCa (40.7%) and BPD (73.7%) groups. Among the factors examined, the PSAD and the presence of histologic inflammation appeared to be independently associated with the detection of PCa. Furthermore, the combined consideration of these 2 independent factors could differentiate PCa from BPD in the biopsy specimens with a sensitivity, specificity, positive predictive value, and negative predictive value of 87.2%, 63.2%, 78.1%, and 76.6%, respectively.


CONCLUSIONS
It seems possible to avoid unnecessary repeat biopsy using the PSAD and the presence of histologic inflammation in biopsy specimens in patients with continuously elevated serum PSA levels after the initial biopsy.
Terakawa
Tomoaki
T
Division of Urology, Kobe University Graduate School of Medicine, Kobe, Japan.
Miyake
Hideaki
H
Kanomata
Naoki
N
Kumano
Masafumi
M
Takenaka
Atsushi
A
Fujisawao
Masato
M
D000368:Aged; D001707:Biopsy, Needle / Q000379:methods*; D006801:Humans; D007249:Inflammation; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D016016:Proportional Hazards Models; D011467:Prostate / Q000473:pathology; D017430:Prostate-Specific Antigen / Q000097:blood*; D011469:Prostatic Diseases / Q000175:diagnosis / Q000473:pathology; D011470:Prostatic Hyperplasia / Q000175:diagnosis / Q000473:pathology; D011471:Prostatic Neoplasms / Q000097:blood* / Q000175:diagnosis* / Q000628:therapy*; D012680:Sensitivity and Specificity
D017430:Prostate-Specific Antigen