PSA change after antibiotic treatment should not affect decisionmaking on performing a prostate biopsy.
Antibacterial agents
multiparametric magnetic resonance imaging
prostate cancer
prostate-specific antigen
Journal
Turkish journal of medical sciences
ISSN: 1303-6165
Titre abrégé: Turk J Med Sci
Pays: Turkey
ID NLM: 9441758
Informations de publication
Date de publication:
Feb 2023
Feb 2023
Historique:
received:
18
11
2021
accepted:
23
12
2022
entrez:
22
3
2023
pubmed:
23
3
2023
medline:
24
3
2023
Statut:
ppublish
Résumé
To investigate the effect of antibiotic treatment on PSA when deciding on prostate biopsy. A total of 206 patients with an elevated PSA level (2.5-30) were included. Mp-MRI could be done on 129 patients. Patients were given ciprofloxacin (500 mg, b.i.d. p.o.) for 4 weeks and PSA measurements were repeated. Systematic prostate biopsy was performed regardless of PSA changes on all patients. Additionally, cognitive biopsies were performed from PI-RADs III, IV, and V lesions. : Prostate cancer was detected in 36.4% of patients. 53.3% had Gleason score of 3+3, 46.7% had Gleason score ≥ 3+4. PSA values decreased in 56.3% and in 43.7% and remained the same or increased but cancer detection rates were not different: 34.5% vs. 38.9%, respectively (p = 0.514). PSA change in whole group was significant (6.38 ng/mL vs. 5.95 ng/mL, respectively (p = 0.01). No significant PSA decrease was observed in cancer patients (7.1 ng/mL vs. 7.05 ng/mL, p = 0.09), whereas PSA decrease was significant in patients with benign pathology (6.1 ng/mL vs. 5.5 ng/mL, p = 0.01). In patients with PI-RADs IV-V lesions, adenocarcinoma was present in 33.9% and 30.4% with or without PSA decrease, respectively (p = 0.209). Clinically significant cancer was higher in patients with after antibiotherapy PSA values >4 ng/mL regardless of PI-RADs grouping (p = 0.08). Addition of any PSA value to PI-RADs grouping did not have any significant effect on the detection of cancer. PSA change after antibiotic treatment has no effect in detecting cancer and should not delay performing a biopsy.
Sections du résumé
BACKGROUND
BACKGROUND
To investigate the effect of antibiotic treatment on PSA when deciding on prostate biopsy.
METHODS
METHODS
A total of 206 patients with an elevated PSA level (2.5-30) were included. Mp-MRI could be done on 129 patients. Patients were given ciprofloxacin (500 mg, b.i.d. p.o.) for 4 weeks and PSA measurements were repeated. Systematic prostate biopsy was performed regardless of PSA changes on all patients. Additionally, cognitive biopsies were performed from PI-RADs III, IV, and V lesions.
RESULTS
RESULTS
: Prostate cancer was detected in 36.4% of patients. 53.3% had Gleason score of 3+3, 46.7% had Gleason score ≥ 3+4. PSA values decreased in 56.3% and in 43.7% and remained the same or increased but cancer detection rates were not different: 34.5% vs. 38.9%, respectively (p = 0.514). PSA change in whole group was significant (6.38 ng/mL vs. 5.95 ng/mL, respectively (p = 0.01). No significant PSA decrease was observed in cancer patients (7.1 ng/mL vs. 7.05 ng/mL, p = 0.09), whereas PSA decrease was significant in patients with benign pathology (6.1 ng/mL vs. 5.5 ng/mL, p = 0.01). In patients with PI-RADs IV-V lesions, adenocarcinoma was present in 33.9% and 30.4% with or without PSA decrease, respectively (p = 0.209). Clinically significant cancer was higher in patients with after antibiotherapy PSA values >4 ng/mL regardless of PI-RADs grouping (p = 0.08). Addition of any PSA value to PI-RADs grouping did not have any significant effect on the detection of cancer.
DISCUSSION
CONCLUSIONS
PSA change after antibiotic treatment has no effect in detecting cancer and should not delay performing a biopsy.
Identifiants
pubmed: 36945961
doi: 10.55730/1300-0144.5571
pmc: PMC10388076
doi:
Substances chimiques
Prostate-Specific Antigen
EC 3.4.21.77
Anti-Bacterial Agents
0
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
183-192Références
J Urol. 1994 Jun;151(6):1571-4
pubmed: 7514690
J Urol. 2002 Apr;167(4):1723-6
pubmed: 11912396
Prostate Int. 2017 Jun;5(2):59-64
pubmed: 28593168
J Urol. 1990 Apr;143(4):747-52
pubmed: 1690309
Urology. 2011 Aug;78(2):250-5
pubmed: 21705048
Eur Urol. 2001 May;39(5):538-43
pubmed: 11464034
Prostate Cancer Prostatic Dis. 2008;11(2):148-52
pubmed: 17637759
JAMA. 1997 May 14;277(18):1452-5
pubmed: 9145717
J Urol. 2009 Jan;181(1):128-32
pubmed: 19012907
Am J Clin Oncol. 2012 Oct;35(5):490-2
pubmed: 21577087
Can Urol Assoc J. 2013 May-Jun;7(5-6):E293-8
pubmed: 22398204
Int J Cancer. 2015 Mar 1;136(5):E359-86
pubmed: 25220842
J Med Liban. 2002 Jan-Apr;50(1-2):23-5
pubmed: 12841309
Eur Urol. 2004 Apr;45(4):444-8; discussion 448-9
pubmed: 15041107
BJU Int. 2017 Feb;119(2):225-233
pubmed: 26935594
Cancer. 1981 Sep 1;48(5):1229-32
pubmed: 6168364
Cancer Causes Control. 2016 Dec;27(12):1465-1474
pubmed: 27830401
J Clin Lab Anal. 1990;4(2):135-7
pubmed: 1690280
J Urol. 2020 Dec;204(6):1141-1149
pubmed: 32716687
J Urol. 1997 Aug;158(2):505-8; discussion 508-9
pubmed: 9224334
Int J Clin Oncol. 2020 Jan;25(1):175-186
pubmed: 31473884
Urology. 2016 Apr;90:32-7
pubmed: 26802800