PURPOSE: We quantify the causes of elevated serum prostate specific antigen (PSA) concentrations in men whose prostate biopsies repeatedly showed no cancer. MATERIALS AND METHODS: The effects of prostate volume, inflammation, echogenicity on ultrasound and calculi were examined in a large PSA-based screening population of 148 men with serum PSA concentrations greater than 4.0 ng./ml., findings suspicious for cancer on digital rectal examination and multiple negative biopsies. These men were selected and compared to 64 men with suspicious rectal examinations, multiple negative biopsies and serum PSA concentrations of 4.0 ng./ml. or less. RESULTS: The high PSA group had larger prostates (68 versus 33 cc, p = 0.0001) and significantly more subclinical prostatic inflammation. Acute and chronic inflammation was more prevalent in the high PSA group (63% versus 27%, p = 0.0001 and 99% versus 77%, p = 0.0001, respectively). A simultaneous regression analysis showed that prostatic size accounted for 23%, inflammation 7%, prostatic calculi 3% and nonisoechoic ultrasound lesions 1% of the serum PSA variance. CONCLUSIONS: Prostate volume and inflammation are the most important factors contributing to serum PSA elevation in men without clinically detectable prostate cancer.
PURPOSE: We quantify the causes of elevated serum prostate specific antigen (PSA) concentrations in men whose prostate biopsies repeatedly showed no cancer. MATERIALS AND METHODS: The effects of prostate volume, inflammation, echogenicity on ultrasound and calculi were examined in a large PSA-based screening population of 148 men with serum PSA concentrations greater than 4.0 ng./ml., findings suspicious for cancer on digital rectal examination and multiple negative biopsies. These men were selected and compared to 64 men with suspicious rectal examinations, multiple negative biopsies and serum PSA concentrations of 4.0 ng./ml. or less. RESULTS: The high PSA group had larger prostates (68 versus 33 cc, p = 0.0001) and significantly more subclinical prostatic inflammation. Acute and chronic inflammation was more prevalent in the high PSA group (63% versus 27%, p = 0.0001 and 99% versus 77%, p = 0.0001, respectively). A simultaneous regression analysis showed that prostatic size accounted for 23%, inflammation 7%, prostatic calculi 3% and nonisoechoic ultrasound lesions 1% of the serum PSA variance. CONCLUSIONS: Prostate volume and inflammation are the most important factors contributing to serum PSA elevation in men without clinically detectable prostate cancer.
Authors: Daniel Kagedan; Irene Lecker; Ihor Batruch; Christopher Smith; Ilia Kaploun; Kirk Lo; Ethan Grober; Eleftherios P Diamandis; Keith A Jarvi Journal: Clin Proteomics Date: 2012-02-06 Impact factor: 3.988
Authors: Brian T Helfand; Stacy Loeb; Qiaoyan Hu; Phillip R Cooper; Kimberly A Roehl; Barry B McGuire; Nikola A Baumann; William J Catalona Journal: J Urol Date: 2013-02-27 Impact factor: 7.450