Objectives In men ascending Chlamydia trachomatis (CT) infection may result in the inflammatory process in the prostate. It has been suggested that chronic inflammation and infectious agents related to prostatitis may be involved in prostate cancer (PrCa) susceptibility. Nevertheless, the role of CT in the pathogenesis of this common among sexually active men morbidity is still not clear. Better understanding of the host's response to CT and the precise pathways in the PrCa development are of great interest. Up to now prostate biopsy (PBx) remains the only test that can confirm the diagnosis of PrCa. Serum prostate-specific antigen (PSA) test has been used worldwide to screen men for PrCa but can results in a significant proportion of negative PBx and prostate cancer antigen 3 (PCA3, first catch of the urine collected after prostate massage) test may be of valuable help in some PSA quandary situations. We present a clinical case with symptomatic CT infection affecting the PrCa diagnosis.
Methods In October 2010, a white man 38 y.o. with a history of unprotected sex and followed lower urinary tract symptoms (LUTS) and erectile dysfunction for more than 3 months was applying for STIs and PrCa testing. CT infection was detected by RT-PCR. Physical and digital rectal examinations (DRE) were performed and the number of WBC in the prostate secretion was counted. The results of PSA and PCA3 tests resulted in PBx.
Results The results are presented in the Abstract P3-S1.04 table 1. CT positivity was assessed in St. Petersburg by in-house RT-PCR test that was confirmed by an internationally validated molecular test as it has been described elsewhere. No other STIs were detected. The prescribed treatment succeeded: LUTS were released, no CT infection was detected. Interestingly, serum PSA tests showed abnormal results before and 1 month after antibacterial treatment. A cut-off score was exceeded in an additionally prescribed PCA3 test. PBx was performed but histological examination revealed no evidence of PCa but prostate inflammation.
Conclusions Further studies to evaluate the time course of prostatitis/STIs on PrCa risk, particularly among a young cohort of men, have been warranted. New diagnostic markers are needed to investigate the pathways between the acquisition of CT and its impact on the prostate. This is the first report on detection of abnormal PSA and PCA3 tests in a Chlamydia-infected man suffering from LUTS, while no PrCa was histologically detected.