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[Chronic prostatic inflammation: a confounding factor in the diagnosis of prostatic cancer]
R Rodríguez Rodríguez1, T Mayayo Dehesa, F Galbis Sanjuan
1Unidad de Ecografía Urológica, Madrid, España.
Objectives:
To evaluate the influence of inflammatory foci of the prostate on the efficacy of PSA and transrectal ultrasound in the diagnosis of prostatic cancer.
Methods:
Ultrasound-guided transrectal biopsy was performed in 399 patients. The results of serum PSA, PSA density and ultrasound characteristics were compared with the pathological findings.
Results:
The mean prostatic volume was greater in the cases with BPH and chronic inflammatory foci than those with prostatic cancer (p < 0.001). Twenty percent of the patients showed suspicious areas vs 75.1% of the cancers (< 0.001); 66.7% of those with chronic inflammatory foci showed classifications vs 40.6% of the cancers (p < 0.001). The patients with chronic inflammatory foci had PSA values that fell in between those of the BPH and cancer groups (p < 0.05). PSA density also showed intermediate values, although they were not significantly different.
Conclusions:
The presence of chronic prostatic inflammatory foci can increase serum PSA levels. To date, it is not possible to identify this group of patients to avoid a biopsy.