抗生素治疗能否剔除炎症所致PSA升高的影响?

Can antibiotic treatment exclude inflammation in the differential diagnosis of elevated PSA?

前列腺炎症引起的前列腺特异性抗原(PSA)水平升高是导致PSA作为肿瘤标记物特异性下降的一个重要因素,鉴于此,有研究者提出对于单纯PSA升高患者穿刺前可给予一段时间抗生素治疗,然而,对于抗生素治疗究竟能否剔除炎症所致PSA升高影响目前仍有争议。有研究认为抗生素治疗能够降低炎症所致PSA升高,从而减少不必要的穿刺活检;也有研究发现抗生素治疗对PSA无明显影响,抗生素治疗后PSA的下降并不意味着患前列腺癌风险的降低。因此尚需进一步研究来确定穿刺前抗生素治疗的价值。

Considering that antibiotic treatment may elevated the level of prostate-specific antigen （PSA） and hence limit the specificity of PSA test for prostate cancer, urologists use empiric antibiotic treatment for men with increased PSA levels. But it is controversial whether antibiotic treatment can exclude inflammation in the differential diagnosis of PSA elevation. Some researchers have found that antibiotic treatment can decrease inflammation-induced PSA elevation and help to reduce unnecessary biopsies, while others have reported that antibiotic treatment has no significant effect on the PSA level, and the lowered level of PSA following antibiotic treatment does not mean the decreased risk of prostate cancer. Further researches are needed to confirm the value of antibiotic treatment before biopsy.