INFLAMMATION IN BENIGN PROSTATIC HYPERPLASIA - CORRELATION WITH PROSTATE-SPECIFIC ANTIGEN VALUE

Purpose: We attempted to identify morphological parameters of benign p rostatic hyperplastic inflammation that correlate with pre-biopsy pros tate specific antigen (PSA) concentrations. Materials and Methods: Pat ients undergoing prostate biopsy at our department were prospectively studied between January 1995 and January 1996. Preoperative blood and 24-hour urine samples were measured for PSA. Biopsy samples harboring exclusively benign prostatic tissue were graded on a 4-point scale for inflammation (0-no inflammatory cells, 1-scattered inflammatory cell infiltrate, 2-nonconfluent lymphoid nodules and 3-large inflammatory a reas with confluence of infiltrate) and aggressiveness (0-no contact b etween inflammatory cells and glandular epithelium; 1-contact between inflammatory cell infiltrate and glandular epithelium; 2-clear but lim ited, that is less than 25% of the examined material, glandular epithe lium disruption, and 3-glandular epithelium disruption on more than 25 % of the examined material). Results: A total of 66 patients with excl usively benign prostatic tissue on prostate biopsies was analyzed. Dif ference between inflammation graded groups was not significant when co nsidering serum or urinary PSA. There was a significant correlation be tween aggressiveness grading and 0.51, p <0.0001), whereas aggressiven ess grading and urinary PSA did not -0.06, p = 0.6). Conclusions: Pros tatic subclinical inflammation is not associated with high urinary PSA . Unless associated with glandular epithelial disruption, density of p rostatic interstitial inflammatory cell infiltrate is not significantl y correlated with serum PSA concentration. We believe that this issue should be considered when interpreting a prostate biopsy.