Published in:
01-03-2010 | Urology - Original Paper
Antibacterial therapy improves the effectiveness of prostate cancer detection using prostate-specific antigen in patients with asymptomatic prostatitis
Published in: International Urology and Nephrology | Issue 1/2010
Login to get accessAbstract
Objectives
To improve prostate cancer (PC) detection accuracy among patients with a prostate-specific antigen (PSA) above 4.0 ng/ml and asymptomatic prostate inflammation.
Materials and methods
A total of 136 patients with PSA ranging from 4.0 to 50.0 ng/ml with asymptomatic prostatitis were included in the study cohort. All these patients underwent antibacterial therapy for 2 weeks followed by repeat PSA determination and transrectal ultrasound–guided needle prostate biopsy. The PSA, PSAD (PSA density), and f/t PSA (free/total PSA) before and after antibacterial therapy were compared using t-test. The receiver-operating characteristic (ROC) technique was used to evaluate the effectiveness of PSA, PSAD, f/t PSA, and their changes after antibacterial therapy (△PSA, △PSAD, and △f/t PSA) on PC detection.
Results
Among the 136 patients, 33 had PC and the other 103 histologically confirmed benign prostatic disease. After antibacterial therapy for 2 weeks, the PSA (mean ± standard deviation) decreased from 14.0 ± 7.8 ng/ml to 10.4 ± 7.7 ng/ml (P < 0.01). The △PSA, △PSAD, and △f/tPSA were −3.60 ± 4.3 ng/ml, −0.1 ± 0.1 ng/ml/ml, and −0.1 ± 0.1 respectively. The areas under ROC curve were 0.29 for PSA, 0.64 for PSAD, and 0.50 for f/t PSA. The areas under ROC curve were 0.91 for △PSA, 0.96 for △PSAD, and 0.98 for △f/t PSA. These values were increased significantly when compared with those for the PSA-related parameters before antibacterial therapy (P value, △PSA, △PSAD, and △f/t PSA were <0.01).
Conclusions
Using the changes in PSA-related parameters after antibacterial therapy △PSA, △PSAD, and △f/t PSA improve the PC detection rate and decrease unnecessary prostate biopsies in patients with asymptomatic prostatitis.