Prostate-specific antigen levels in acute and chronic bacterial prostatitis

Abstract

急性および慢性前立腺炎患者のPSAを測定した。PSAは炎症の急性期に上昇する傾向が有り, 適切な抗菌剤の使用により全例14日以内に正常化した。慢性前立腺炎患者に治療後もなおPSAが正常化しない症例が1例あり, 経直腸的超音波検査と生検により前立腺癌と診断された

Prostate-specific antigen (PSA) is now widely accepted as a useful tumor marker for the diagnosis and follow-up of prostatic cancer. An elevated level of PSA has been asserted to be highly specific for prostate cancer, although patients with large benign prostate glands and those with bacterial prostatitis may also have slightly elevated levels. We measured the serum PSA level in the patients with acute and chronic bacterial prostatitis and consecutively monitored the PSA level in 6 patients who had acute prostatitis and an elevated PSA level. The PSA level was found to be elevated during the acute phase of prostatic inflammation, and the elevated, PSA level in the patients with acute prostatitis returned to the normal level within 14 days after initiation of antimicrobial therapy in all 6 patients. In one patient with chronic prostatitis the elevated PSA level persisted after antibiotic treatment. He was found to have adenocarcinoma by transrectal ultrasonography and biopsy. A markedly elevated serum PSA level in bacterial prostatitis can cause confusion in the diagnosis of prostatic carcinoma. Therefore, PSA determination should be obtained after complete clinical resolution of inflammation to exclude prostatic malignant involvement.