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전립샘특이항원 수치가 증가되어 건강증진센터에서 의뢰된 45세 미만 무증상 남성에서 항원수치의 변화 양상

The Pattern of Change for the Prostate-specific Antigen (PSA) Level in Asymptomatic Men Under 45-years-old who were Referred from a Health Promotion Center due to an Elevated PSA Level

대한비뇨기과학회지 2008년 49권 9호 p.809 ~ 812
이명호 ( Lee Myung-Ho ) - 순천향대학교 의과대학 비뇨기과학교실

박영호 ( Park Young-Ho ) - 순천향대학교 의과대학 비뇨기과학교실
송윤섭 ( Song Yun-Seob ) - 순천향대학교 의과대학 비뇨기과학교실
양원재 ( Yang Won-Jae ) - 순천향대학교 의과대학 비뇨기과학교실

Abstract


Purpose: To reveal the pattern of change of the prostate-specific antigen (PSA) level in asymptomatic men younger than 45 years whose PSA level was ≥4.00ng/ml.

Materials and Methods: Between January 2003 to October 2007, 105 men (<45-year-old) and 285 men(≥45-year-old) were respectively referred from a health promotion center due to an elevated PSA level(≥4.00 ng/ml). Among them, the men with prostatitis-associated symptoms and pyuria(≥5WBC/HPF) on urinalysis, those taking medication that influence the PSA level or those men with a short follow-up period(<6 months) were excluded. The pattern of change of the PSA level in men younger than 45 years(group 1) was analyzed, and the results were compared with those of men whose age was ≥45 years(group 2).

Results: The data from 38(group 1) and 87(group 2) men was finally analyzed respectively. In group 1, the median age was 41(25-44) and the initial PSA level was 5.60ng/ml (4.10-17.00). The PSA levels in 31 men (81.6%) decreased spontaneously during a median follow-up period of 20 months, and the PSA levels in 18 men(47.4%) were spontaneously normalized(<4.00ng/ml), and both of which were significantly higher as compared with those values in group 2(48.3% and 28.7% respectively). Prostate biopsies were performed in 3 men(group 1), and 33 men(group 2); all of these revealed benign disease.

Conclusions: Despite of an abnormal elevation of PSA, if men are younger than 45 years and they have no specific urologic symptoms, there is little need for immediate exploration for prostatitis or to prescribe antibiotics because the PSA levels decline spontaneously in many cases.

키워드

Prostate-specific antigen;Prostatitis;Prostatic neoplasms
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