Asymptomatic prostatic inflammation in men with clinical BPH and erectile dysfunction affects the positive predictive value of prostate-specific antigen

Agnihotri, Shalini; Mittal, Rama Devi; Kapoor, Rakesh; Mandhani, Anil

doi:10.1016/j.urolonc.2014.03.004

Cited by 14 publications

(11 citation statements)

References 26 publications

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“…As mentioned above, The PSA release is elevated due to the activation of androgen receptors stimulated by in ammatory cytokines [7]. The study of Agnihotri et al suggested that signi cant in ammation of the prostate resulted in spurious rise in serum PSA level [16]. This conclusion was also con rmed in young men [17].…”

Section: Resultsmentioning

confidence: 87%

WITHDRAWN: Diagnosis of Chronic Prostatitis by Noninvasive Methods in Elderly Patients with Benign Prostatic Hyperplasia in China

Cao

Guan

et al. 2020

Preprint

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Background: Chronic prostatitis is hard to be identified in benign prostatic hyperplasia (BPH) patients in clinical works. This study aimed to diagnose chronic prostatitis in BPH patients by noninvasive methods.Methods: The research was carried out on the BPH patients who received transurethral resection of prostate at Xinhua hospital from January 2014 to Jul 2015. Before operation, patients were asked for medical history and required to receive physical examination, serum sample collection including PSA, sex hormones, inflammatory cytokines, metabolic panel and transrectal ultrasonography. According to histological results, the patients were divided into 2 group of BPH with/without prostatitis. Logistic regression was used to find the risk factors of chronic prostatitis.Results: As a result, 181 men with an average age of 72.15±8.41 years were enrolled in this study, including 116 patients with prostatitis and 65 patients without prostatitis. The storage sub-score (9.24±1.55 vs 8.52±1.63, p=0.009), PSA (8.23±7.69 vs 4.92±3.84, p=0.005) and IL-2R (531.96±200.75 vs 434.11±153.54, p=0.001) were significantly higher in patients with prostatitis than those without prostatitis. Based on logistic regression analysis, the above three parameters were also the risk factors of BPH with prostatitis. The diagnostic model was calculated as: 0.317* storage sub-score+0.092* PSA+0.003* IL-2R-4.296. The AUC was 0.725. Conclusions: Histological prostatitis in BPH patients can be diagnosed by the combination of serum IL-2R, PSA and storage sub-score. Identification of chronic prostatitis among patients with BPH is beneficial for medical decisions, which can more efficiently alleviate urinary symptoms and reduce the risk of disease progression.

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Section: Resultsmentioning

confidence: 87%

WITHDRAWN: Diagnosis of Chronic Prostatitis by Noninvasive Methods in Elderly Patients with Benign Prostatic Hyperplasia in China

Cao

Guan

et al. 2020

Preprint

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“…IL-8 levels in the prostatic fluid were examined in order to detect serum total and free PSA levels and inflammation of the patients. It was shown that total PSA level and IL-8 level in prostatic fluid were statistically significantly higher in symptomatic patient group compared to the control group (22). In another study evaluating the relation between AUR and prostatic inflammation, 232 patients who had TURP due to BPH were included.…”

Section: Discussionmentioning

confidence: 99%

Prostat Spesifik Antijenin Akut Üriner Retansiyon Sonrası Üretral Kateter Yerleştirilen ve Benign Prostat Hiperplazisi Olan Hastalarda Prostat Adenokarsinomu Saptamadaki Rolü

Hacıislamoğlu¹,

Evren²,

Yavuzsan³

et al. 2020

Yeni Üroloji Dergisi

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Akut idrar retansiyonu (AİR) benign prostat hiperplazisi (BPH) hastalarında en önemli komplikasyonlardan biridir ve tedavisi genellikle akut dönemde üretral kateterizasyondur. AİR ve üretral kateter yerleştirilmesinin serum PSA seviyelerinde bir artışa neden olabileceğini gösteren çalışmalar vardır. Bu çalışmada amacımız, AİR sonrası üretral kateter yerleştirilen hasta grubunda artmış PSA düzeyleri ile prostat kanseri (PCa) insidansı arasındaki ilişkiyi araştırmaktır. Gereç ve Yöntemler: AUR nedeniyle kalıcı bir üretral kateteri olan 77 hastada, yüksek PSA seviyeleri nedeniyle yapılan prostat biyopsileri ve daha sonra klinik BPH için yapılan cerrahi tedaviler retrospektif olarak incelendi. Hastaların yaş, prostat hacimleri, biyopsi öncesi total serum PSA ve PSA dansiteleri kaydedildi. Biyopsi veya cerrahi örnek sonuçlarına göre total PSA oranları, PSA dansiteleri ve prostat hacimleri PCa'nın saptandığı (n = 6) ve saptanmadığı (n = 71) gruplar için karşılaştırıldı. Bulgular: Hastaların yaş ortalaması 65.2 ± 3.9 idi. Ortalama prostat hacmi 64.1 ± 12.8 g, ortalama serum total PSA seviyesi 9.2 ± 4.2 ng / mL ve ortalama serum PSA dansitesi 0.15 ± 0.08 mg / mL / g olarak ölçülmüştür. Serum total PSA düzeyi ≤4.0, 4-10, 10-20 ve >20 olan PSA gruplarında PCa prevalansı sırasıyla % 0, % 4,3, % 13,4 ve % 20 olarak tespit edildi. Toplam PSA düzeyleri ve PSA dansiteleri, PCa tespit edilen grupta istatistiksel olarak daha yüksek bulundu. Sonuç: AİR sonrası üretral kateter yerleştirilen hastalarda PCa insidansı düşüktür. Bu hastalar için prostat biyopsisi sadece seçilmiş vakalarda yapılmalıdır.

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“…Similar observation of higher PSA level due to underlying prostatic inflammation in symptomatic BPH patients with normal DRE was also found in another study conducted in the Indian context. [ 13 ]…”

Section: Discussionmentioning

confidence: 99%

“…It can be due to associated underlying inflammation in prostate. [ 13 ] Tests done to identify patients at high risk of prostatic malignancy at range 4–10 ng/ml so as to decide for prostatic biopsy are not widely available in India (percent-free PSA, PCA 3 test). Cost of TRUS biopsy in a government hospital in India is negligible, but in private setup, cost increases to Rs.…”

Section: Discussionmentioning

confidence: 99%

An overview of serum prostatic surface antigen cut points for recommendation of prostatic biopsy

et al. 2018

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Introduction:Patients in India frequently present with prostatic surface antigen (PSA) report and request for prostatic biopsy to rule out malignancy. With fear of harboring malignancy set in patient's mind, it becomes difficult to counsel them about absolute indications and need of biopsy. Whether serum PSA has same predictability in symptomatic patients in the Indian context for advising prostatic biopsy at same reference ranges as in western countries, remains to be answered.Materials and Methods:Symptomatic patients between 45 and 70 years of age presenting with either raised serum PSA (>4 ng/ml) reports or abnormal digital rectal examination (DRE) were considered as cases. Standard 12 core transrectal ultrasound-guided prostatic biopsy was done. Statistical analysis using optimal cut points, an R package was done to overview different PSA cut points for the recommendation of prostatic biopsy.Results:A total of 534 patients were included. Mean age was 64 years. Malignancy was detected in total 77 patients (14.42%). Malignancy was identified in 3.59% (10/279) and 30% (63/210) patients at serum PSA ranges 4–10 ng/ml and serum PSA >10 ng/ml, respectively. Both, maximum sensitivity and specificity were found at PSA cut point 9.7 ng/ml. We evaluated these patients to identify the PSA cut point above which unnecessary biopsies will be avoided. We kept power of study maximum, i.e., 1 with confidence interval of 0.95.Conclusion:PSA value 9.7 ng/ml should be considered as the cut point above which prostatic biopsy should be done to avoid unnecessary biopsies. Unless accompanied by abnormal DRE finding at PSA range 4–10 ng/ml, morbidity of prostatic biopsy procedure can be avoided using this cut-point.

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Asymptomatic prostatic inflammation in men with clinical BPH and erectile dysfunction affects the positive predictive value of prostate-specific antigen

Cited by 14 publications

References 26 publications

WITHDRAWN: Diagnosis of Chronic Prostatitis by Noninvasive Methods in Elderly Patients with Benign Prostatic Hyperplasia in China

WITHDRAWN: Diagnosis of Chronic Prostatitis by Noninvasive Methods in Elderly Patients with Benign Prostatic Hyperplasia in China

Prostat Spesifik Antijenin Akut Üriner Retansiyon Sonrası Üretral Kateter Yerleştirilen ve Benign Prostat Hiperplazisi Olan Hastalarda Prostat Adenokarsinomu Saptamadaki Rolü

An overview of serum prostatic surface antigen cut points for recommendation of prostatic biopsy

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