PTU - Polskie Towarzystwo Urologiczne
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Inflammation in biopsies of patients suspected for prostate cancer
Article published in Urologia Polska 2008/61/Supl. 1.


Przemysław Adamczyk, Zbigniew Wolski, Romuald Butkiewicz, Joanna Nussbeutel, Bartosz Misterek
Oddział Urologii Ogólnej i Onkologicznej, Specjalistyczny Szpital Miejski w Toruniu
Katedra i Klinika Urologii Ogólnej, Onkologicznej i Dziecięcej Collegium Medicum w Bydgoszczy UMK w Toruniu
Zakład Patomorfologii, Specjalistyczny Szpital Miejski w Toruniu



Inflammation is diagnosed in prostate biopsies along with other prostate diseases quite often. It can lead to rise of PSA, and some authors believe, that may lead to prostate malignant changes.


The aim of the study was to establish a prevalence of prostate inflammation in cores taken from patients subjected to transrectal prostate biopsy.

Materials and methods.

928 males were subjected to biopsy, as being suspected for prostate cancer (according to EAU guidelines). 6-12 core, TRUS-guided, prostate biopsy was preformed. In patients with premalignant lesions (PIN, ASAP), and/or PSA rise and/or abnormal DRE in first biopsy, second extended biopsy (10-16 cores) was preformed in period of 4-6 months.


In 99 (10.68%) patients prostate inflammation was found, and inflammation along with premalignant High Grade Prostatic Intraepitelial Neoplasia (HG-PIN) in 6 (0,.4%), Atypical small acinar proliferation- (ASAP) in 4 (0,43%) patients was also found. Benign prostatic hyperplasia (BPH) was found in 369 (39.7%) men. Prostate cancer was found in 300 males (32.32%), and cancer along with inflammation in only 3 (1%) of them, all with low Gleason score (3-6). Mean PSA level was higher in inflammation group compared with BPH group (mean 10.5 ng/ml, median 7.88 ng/ml) and was – 12 ng/ml (median 9.15 ng/ml). In group with inflammation co-existing with ASAP mean PSA was 13.1 ng/ml, (median 15.15 ng/ml), HG-PIN and inflammation 13.16 ng/ml (median 12.9 ng/ml), and cancer and inflammation 10.97 ng/ml (median 9.43 ng/ml). Inflammation co-existing with premalignant lesions, raised mean PSA from 11.96 ng/ml (median 9.79 ng/ml) to 13.1 ng/ml (median 15.15 ng/ml) in group with ASAP, and 10.94 ng/ml (median
9.4 ng/ml) to 13.16 ng/ml (median 12.9 ng/ml) in group with HG-PIN. Second biopsy was performed in 78 patients. Prostate cancer was found in 11 (14.1%) of them, and there was no co-existing inflammation with it. It was confirmed in 2 (2.56%) patients with ASAP and 2 with Low Grade Prostatic Intraepitelial Neoplasia (LG-PIN). Second biopsy results were analyzed in aspect of possible cancer development. Cancer was found in 2 patients with ASAP in first biopsy, 3 with HG-PIN, 3 with BPH, 1 with co-existing ASAP and HG-PIN, 2 with co-existing ASAP and LG-PIN. There was no cancer in second biopsy, found in patients with any possible lesion with co-existing prostate inflammation at first.


1. Co-existence of prostate inflammation raises mean and median PSA level in all groups of patients, with no significant difference with any co-existing diagnosis. 2. There was no significant difference in frequency of diagnosis of co-existing cancer with inflammation, and precancerous lesions and inflammation. 3. There was no incidence of cancer on second biopsy, found in patients with any possible lesion with co-existing prostate inflammation in first one.