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Prostate-specific antigen test in diagnostic evaluation of chronic prostatitis/chronic pelvic pain syndrome.
Urology. 2006 Feb; 67(2):337-42.U

Abstract

OBJECTIVES

To determine whether prostate-specific antigen (PSA), the percent free PSA, or free PSA isoforms may be used as diagnostic markers for chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS; National Institutes of Health category IIIa and IIIb).

METHODS

We evaluated 421 patients enrolled in the Chronic Prostatitis Cohort Study and 112 age-matched controls. Subjects were stratified by the number of white blood cells (WBCs) in their expressed prostatic secretions and pain as determined by the National Institutes of Health Chronic Prostatitis Symptom Index.

RESULTS

Total PSA, free PSA, and [-2]proPSA ([-2]pPSA) were significantly elevated in those with CP/CPPS compared with controls (mean PSA 1.97 ng/mL versus 1.72 ng/mL, P = 0.03; mean free PSA 0.76 ng/mL versus 0.70 ng/mL, P = 0.01; and [-2]pPSA 2.38 ng/mL versus 1.80 ng/mL, P = 0.04). The percent free PSA was not significantly different between the patients and controls. For those with CP/CPPS, the percent free PSA was significantly lower as the WBC count rose in the expressed prostatic secretions (0 WBCs = 43.29 versus more than 25 WBCs = 26.52; P < .0001). A PSA level of 4.0 ng/mL or greater was found in 10% of patients and 7% of controls (P = 0.03).

CONCLUSIONS

Men with elevated PSA values and CP/CPPS should be treated as one would any other patient screened for prostate cancer with an elevated PSA level. Although PSA, free PSA, and [-2]pPSA were slightly elevated in men with CP/CPPS, the low sensitivity and specificity do not warrant using them as biomarkers for CP/CPPS.

Authors+Show Affiliations

Department of Urology, Northwestern University Feinberg School of Medicine, Chicago, Illinois 60611, USA. r-nadler@northwestern.eduNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, N.I.H., Extramural

Language

eng

PubMed ID

16442595

Citation

Nadler, Robert B., et al. "Prostate-specific Antigen Test in Diagnostic Evaluation of Chronic Prostatitis/chronic Pelvic Pain Syndrome." Urology, vol. 67, no. 2, 2006, pp. 337-42.
Nadler RB, Collins MM, Propert KJ, et al. Prostate-specific antigen test in diagnostic evaluation of chronic prostatitis/chronic pelvic pain syndrome. Urology. 2006;67(2):337-42.
Nadler, R. B., Collins, M. M., Propert, K. J., Mikolajczyk, S. D., Knauss, J. S., Landis, J. R., Fowler, J. E., Schaeffer, A. J., & Alexander, R. B. (2006). Prostate-specific antigen test in diagnostic evaluation of chronic prostatitis/chronic pelvic pain syndrome. Urology, 67(2), 337-42.
Nadler RB, et al. Prostate-specific Antigen Test in Diagnostic Evaluation of Chronic Prostatitis/chronic Pelvic Pain Syndrome. Urology. 2006;67(2):337-42. PubMed PMID: 16442595.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Prostate-specific antigen test in diagnostic evaluation of chronic prostatitis/chronic pelvic pain syndrome. AU - Nadler,Robert B, AU - Collins,Mary McNaughton, AU - Propert,Kathleen J, AU - Mikolajczyk,Stephen D, AU - Knauss,Jill S, AU - Landis,J Richard, AU - Fowler,Jackson E,Jr AU - Schaeffer,Anthony J, AU - Alexander,Richard B, AU - ,, Y1 - 2006/01/25/ PY - 2005/03/29/received PY - 2005/07/22/revised PY - 2005/08/12/accepted PY - 2006/1/31/pubmed PY - 2006/4/1/medline PY - 2006/1/31/entrez SP - 337 EP - 42 JF - Urology JO - Urology VL - 67 IS - 2 N2 - OBJECTIVES: To determine whether prostate-specific antigen (PSA), the percent free PSA, or free PSA isoforms may be used as diagnostic markers for chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS; National Institutes of Health category IIIa and IIIb). METHODS: We evaluated 421 patients enrolled in the Chronic Prostatitis Cohort Study and 112 age-matched controls. Subjects were stratified by the number of white blood cells (WBCs) in their expressed prostatic secretions and pain as determined by the National Institutes of Health Chronic Prostatitis Symptom Index. RESULTS: Total PSA, free PSA, and [-2]proPSA ([-2]pPSA) were significantly elevated in those with CP/CPPS compared with controls (mean PSA 1.97 ng/mL versus 1.72 ng/mL, P = 0.03; mean free PSA 0.76 ng/mL versus 0.70 ng/mL, P = 0.01; and [-2]pPSA 2.38 ng/mL versus 1.80 ng/mL, P = 0.04). The percent free PSA was not significantly different between the patients and controls. For those with CP/CPPS, the percent free PSA was significantly lower as the WBC count rose in the expressed prostatic secretions (0 WBCs = 43.29 versus more than 25 WBCs = 26.52; P < .0001). A PSA level of 4.0 ng/mL or greater was found in 10% of patients and 7% of controls (P = 0.03). CONCLUSIONS: Men with elevated PSA values and CP/CPPS should be treated as one would any other patient screened for prostate cancer with an elevated PSA level. Although PSA, free PSA, and [-2]pPSA were slightly elevated in men with CP/CPPS, the low sensitivity and specificity do not warrant using them as biomarkers for CP/CPPS. SN - 1527-9995 UR - https://www.unboundmedicine.com/medline/citation/16442595/Prostate_specific_antigen_test_in_diagnostic_evaluation_of_chronic_prostatitis/chronic_pelvic_pain_syndrome_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0090-4295(05)01187-8 DB - PRIME DP - Unbound Medicine ER -