title: Relationship of chronic histologic prostatic inflammation in biopsy specimens with serum isoform [-2]proPSA (p2PSA), %p2PSA, and prostate health index in men with a total prostate-specific antigen of 4-10 ng/ml and normal digital rectal examination.
abstract: OBJECTIVE
  To investigate the relationship between serum [-2]proPSA (p2PSA) and derivatives with chronic histologic prostatic inflammation (CHPI) in men undergoing prostate biopsy for suspected prostate cancer (PCa).
  
  
  METHODS
  This nested case-control study resulted from an observational prospective trial for the definition of sensibility, specificity, and accuracy of p2PSA, %p2PSA, and Beckman Coulter Prostate Health Index (PHI), in men undergoing prostate biopsy, with a total prostate-specific antigen (PSA) of 4-10 ng/mL and normal digital rectal examination. CHPI was the outcome of interest and defined as the presence of moderate to large infiltration of lymphomononuclear cells with interstitial and/or glandular disruption in absence of PCa. p2PSA, %p2PSA, and PHI were considered the index tests and compared with the established biomarker reference standard tests: tPSA, fPSA, %fPSA.
  
  
  RESULTS
  Of 267 patients subjected to prostate biopsy, 73 (27.3%) patients were diagnosed with CHPI. Comparing CHPI with PCa patients, %p2PSA and PHI were found to be significantly lower, whereas fPSA and %fPSA were significantly higher. %p2PSA and PHI were the most accurate predictors of CHPI at biopsy, significantly outperforming tPSA, fPSA, and %fPSA. On the contrary, no significant differences were found in PSA, p2PSA, and derivatives between CHPI and benign prostatic hyperplasia (BPH) patients.
  
  
  CONCLUSIONS
  Our findings showed that p2PSA, %p2PSA, and PHI values might discriminate PCa from CHPI or BPH, but not CHPI from BPH, in men with a total PSA 4-10 ng/mL and normal digital rectal examination. p2PSA isoform and its derivatives could be useful in clinical decision making to avoid unnecessary biopsies in patients with CHPI and elevated tPSA value.
authors: Department of Urology, Ospedale San Raffaele Turro, San Raffaele Scientific Institute, Milan, Italy.
authors: Massimo
authors: M
authors: Lazzeri
authors: Department of Urology, Ospedale San Raffaele Turro, San Raffaele Scientific Institute, Milan, Italy. Electronic address: alberto.abrate@gmail.com.
authors: Alberto
authors: A
authors: Abrate
authors: Department of Urology, Ospedale San Raffaele Turro, San Raffaele Scientific Institute, Milan, Italy.
authors: Giovanni
authors: G
authors: Lughezzani
authors: Department of Urology, Ospedale San Raffaele Turro, San Raffaele Scientific Institute, Milan, Italy.
authors: Giulio Maria
authors: GM
authors: Gadda
authors: Department of Pathology, Ospedale San Raffaele, San Raffaele Scientific Institute, Milan, Italy.
authors: Massimo
authors: M
authors: Freschi
authors: Department of Urology, Ospedale San Raffaele Turro, San Raffaele Scientific Institute, Milan, Italy.
authors: Francesco
authors: F
authors: Mistretta
authors: Department of Urology, Ospedale San Raffaele Turro, San Raffaele Scientific Institute, Milan, Italy.
authors: Giuliana
authors: G
authors: Lista
authors: Department of Urology, Ospedale San Raffaele Turro, San Raffaele Scientific Institute, Milan, Italy.
authors: Nicola
authors: N
authors: Fossati
authors: Department of Urology, Ospedale San Raffaele Turro, San Raffaele Scientific Institute, Milan, Italy.
authors: Alessandro
authors: A
authors: Larcher
authors: Department of Urology, Ospedale San Raffaele Turro, San Raffaele Scientific Institute, Milan, Italy.
authors: Ella
authors: E
authors: Kinzikeeva
authors: Department of Urology, Ospedale San Raffaele Turro, San Raffaele Scientific Institute, Milan, Italy.
authors: Nicolòmaria
authors: N
authors: Buffi
authors: Department of Urology, Ospedale San Raffaele Turro, San Raffaele Scientific Institute, Milan, Italy.
authors: Vincenzo
authors: V
authors: Dell'Acqua
authors: Department of Internal Medicine, University of Perugia, Perugia, Italy.
authors: Vittorio
authors: V
authors: Bini
authors: Department of Urology, Ospedale San Raffaele Turro, San Raffaele Scientific Institute, Milan, Italy.
authors: Francesco
authors: F
authors: Montorsi
authors: Department of Urology, Ospedale San Raffaele Turro, San Raffaele Scientific Institute, Milan, Italy.
authors: Giorgio
authors: G
authors: Guazzoni
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002908:Chronic Disease; D051517:Digital Rectal Examination; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D017430:Prostate-Specific Antigen / Q000097:blood*; D011470:Prostatic Hyperplasia / Q000097:blood* / Q000473:pathology; D011471:Prostatic Neoplasms / Q000097:blood* / Q000473:pathology; D011472:Prostatitis / Q000097:blood* / Q000473:pathology; D011498:Protein Precursors / Q000097:blood*; D012680:Sensitivity and Specificity; D012720:Severity of Illness Index
chemical_list: C583834:(-2)pro-prostate-specific antigen, human; D011498:Protein Precursors; D017430:Prostate-Specific Antigen