Volume 8, Issue 2 (Fall & Winter 2025)
J Res Urol 2025, 8(2): 0-0 |
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masoumi N, Farajpour M, seyed Hosseini S S, Alirezaei A H. Prostate Biopsy in Type 4 Prostatitis with PSA 4–10: Role of Leukocyte Count in EPS. J Res Urol 2025; 8 (2)
URL: http://urology.umsha.ac.ir/article-1-177-en.html
URL: http://urology.umsha.ac.ir/article-1-177-en.html
1- , Mostafa.farajpour.kh@gmail.com
Abstract: (17 Views)
Background and Objective:
This study evaluates the predictive value of leukocyte count in expressed prostatic secretions (EPS) for differentiating type IV prostatitis from prostate cancer (PCa) in patients with PSA levels between 4 and 10 ng/mL. The aim is to assess EPS's ability to reduce unnecessary biopsies and enhance diagnostic accuracy.
Materials and Methods:
In a prospective cross-sectional study, 88 patients over 40 years with PSA levels between 4 and 10 ng/mL and no symptoms of acute or chronic bacterial prostatitis were evaluated. EPS was collected via prostate massage, and white blood cell (WBC) counts were analyzed at thresholds of >5 and >10 per high-power field (HPF). All patients underwent transrectal ultrasound (TRUS)-guided prostate biopsy. Data were analyzed using SPSS version 23, and diagnostic performance was assessed via receiver operating characteristic (ROC) curve analysis.
Findings:
Type IV prostatitis was found in 54.5% of patients and PCa in 36.4%. Among patients with positive EPS, 25% (WBC >5) and 12.5% (WBC >10) had PCa (P=0.03 for WBC >10). Sensitivity and specificity were 46.4% and 70% for WBC >5, and 50% and 68% for WBC >10, respectively. EPS testing reduced unnecessary biopsies by 16–24%.
Conclusion:
Leukocyte counting in EPS is a valuable, non-invasive tool for differentiating type IV prostatitis from PCa. The >10 WBC/HPF threshold can reduce unnecessary biopsies and improve diagnostic efficiency. Larger multicenter studies are recommended to optimize this approach.
This study evaluates the predictive value of leukocyte count in expressed prostatic secretions (EPS) for differentiating type IV prostatitis from prostate cancer (PCa) in patients with PSA levels between 4 and 10 ng/mL. The aim is to assess EPS's ability to reduce unnecessary biopsies and enhance diagnostic accuracy.
Materials and Methods:
In a prospective cross-sectional study, 88 patients over 40 years with PSA levels between 4 and 10 ng/mL and no symptoms of acute or chronic bacterial prostatitis were evaluated. EPS was collected via prostate massage, and white blood cell (WBC) counts were analyzed at thresholds of >5 and >10 per high-power field (HPF). All patients underwent transrectal ultrasound (TRUS)-guided prostate biopsy. Data were analyzed using SPSS version 23, and diagnostic performance was assessed via receiver operating characteristic (ROC) curve analysis.
Findings:
Type IV prostatitis was found in 54.5% of patients and PCa in 36.4%. Among patients with positive EPS, 25% (WBC >5) and 12.5% (WBC >10) had PCa (P=0.03 for WBC >10). Sensitivity and specificity were 46.4% and 70% for WBC >5, and 50% and 68% for WBC >10, respectively. EPS testing reduced unnecessary biopsies by 16–24%.
Conclusion:
Leukocyte counting in EPS is a valuable, non-invasive tool for differentiating type IV prostatitis from PCa. The >10 WBC/HPF threshold can reduce unnecessary biopsies and improve diagnostic efficiency. Larger multicenter studies are recommended to optimize this approach.
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