血清PSA轻度增高对无症状前列腺炎的筛查意义

目的 探讨血清前列腺特异性抗原（PSA）与无症状前列腺炎（Ⅳ型）的关系。方法对血清PSA4～10ng／mL，肛门指检正常且无前列腺炎症状的102名体检者，进行前列腺按摩液（EPS）或前列腺按摩后尿液（VB3）检查，若EPS中WBC〉10／HP或VB，离心后WBC〉10／HP，则诊断为Ⅳ型前列腺炎，给予6周治疗后复查血清PSA。结果102例中诊断Ⅳ型前列腺炎28例（27．5％）。治疗后13例血清PSA〈4ng／mL，随访6月其血清PSA仅平均上升3．8％（P〉0．05）；15例血清PSA仍高于4ng／mL者行前列腺穿刺活检，病理证实前列腺癌6例，慢性炎症、前列腺增生、正常前列腺组织各3例。结论对血清PSA轻度增高且肛门指检正常者应进行Ⅳ型前列腺炎的筛检，经确诊给予相应治疗后半数患者血清PSA可恢复至正常，从而避免前列腺穿刺活检。

Significance of Identification of Asymptomatic Prostatitis in Men with Elevated Serum PSA

Objective To investigate the changes of serum prostate specific antigen(PSA) in asymptomatic prostatitis. Methods One hundred and two asymptomatic patients with serum PSA 4~10 ng/mL were screened for asymptomaticprostatitis. These patients diagnosed with asymptomatic prostatitis were given a 6-week course of treatment. After treatment, the serum PSA levels were measured again. Results The prevalence of asymptomatic prostatitis was 27.5% in our series. Thirteen patients (46.4%) were with serum PSA <4 ng/mL. After a mean of 6 monthsfollow up, mean PSA increased only 3.8%( P>0.05). The remaining 15 patients with elevated serum PSA underwent transrectal ultrasound guided biopsy. Pathologic study showed prostate cancer, chronic inflammation,benign prostatic hypertrophy and normal prostate tissue in 6 (40.0%), 3(20.0%),3(20.0%), 3(20.0%) patients, respectively. Conclusion Asymptomatic prostatitis is fairly prevalent in the patients with serum PSA 4~10 ng/mL. About half of the patients with serum PSA normalized after treatment no longer need prostate biopsy.