Does the type of prostatic atrophy influence the association of extent of atrophy in needle biopsies and serum prostate-specific antigen levels?

Objectives: To consider the possibility that a positive and significant association between extent of atrophy and serum total or free prostate-specific antigen (PSA) elevation in patients with biopsies showing no cancer, high-grade prostatic intra-epithelial neoplasia or areas suspicious for cancer found in a previous study may be related to the type of atrophy.
Methods: The only diagnosis in 75 extended biopsies was focal prostatic atrophy. Both partial and complete atrophy were considered. Complete atrophy was subtyped into simple, hyperplastic, and sclerotic atrophy. The extent of each type of atrophy was measured in 2 ways: the linear extent in millimeters and the percentage of linear extent showing atrophy for each biopsy. On the basis of the median value of serum total PSA, the patients were divided into 2 groups: group A patients with PSA <or= 8.2 ng/mL, and group B patients with PSA > 8.2 ng/mL.
Results: There was a positive and statistically significant correlation of the linear atrophy extent as well as the percentage of linear extent with total and free serum PSA level. There was no statistically significant difference in the distribution of extent according to the type of atrophy between groups A and B.
Conclusions: There is a positive and significant association between extent of atrophy and serum PSA elevation. This association is not related to the type of atrophy. We hypothesize that stress-induced response by inflammation and/or ischemia may interfere in the physiological barrier that prevents any significant amount of PSA to gain the general circulation.