Clinical Significances Of Zinc, PSA And Routine Inspection Index Of Expressed Prostatic Secretion In Diagnosis And Treatment Of Chronic Nonbacterial Prostatitis

Objective:This study was aimed to compare the levels of zinc and PSA in expressed prostatic secretion (EPS) of patients with chronic nonbacterial prostatitis and normal control group, and explore the value of determining the levels of zinc, PSA and routine inspection index in EPS in assessing the Severity and guiding treatment of chronic nonbacterial prostatitis.Methods:A total of 261 EPS specimens were collected from patients with chronic nonbacterial prostatitis, and 144,65 and 52 patients were respectively classified as category ⅢA, ⅢB and Ⅳ prostatitis. Another 97 EPS specimens were also collected from the control group. The severity and symptoms of chronic prostatitis were accessed by the National Institutes of Health Chronic Prostatitis Symptom Index (NIH-CPSI). The level of zinc was measured by colorimetric analysis, and PSA was determined by enzyme linked immunosorbent assay (ELISA). The wet mount was examined promptly with a high-power microscope (400 X) for white blood cell(WBC) and lecithin body(LB). The pH value of EPS was determined by pH test strips (pH range 5.5-9.0).Results:Zinc level in EPS of symptomatic category Ⅲ A and ⅢB prostatitis was significantly lower than asymptomatic category IV prostatitis and the control group(all P<0.05). And there was no statistical difference between category ⅢA prostatitis and category IIIB prostatitis in zinc level(P> 0.05), neither between category IV prostatitis and the control group(P>0.05). The PSA level in EPS of normal control group was significantly higher than category III A prostatitis patients (P<0.05). The zinc level in EPS was negatively correlated to NIH-CPSI scores (it includes Pain Scores, Quality of Life Scores, Total CPSI Scores) in all subjects (all P<0.05), but there was no correlation between zinc level and CPSI Urinary Scores(P>0.05). Similarly, PSA level in EPS was negatively correlated to NIH-CPSI scores(it includes Pain Scores, Quality of Life Scores, Total CPSI Scores) in all subjects (all P< 0.05), but there was no correlation between PSA level and CPSI Urinary Scores(P>0.05). Zinc level was positively correlated to PSA level in EPS(P< 0.001). The levels of Zinc and PSA were negatively correlated to WBC count and pH value(all P<0.05). And zinc level was positively correlated to amount of LB(P<0.05), but there was no correlation between PSA level and amount of LB(P>0.05). There was no rank correlation between NIH-CSPI scores and amounts of WBC and LB, neither between WBC count and LB count in EPS of patients with category ⅢA prostatitis(all P>0.05). There was no correlation between NIH-CPSI scores and LB count in EPS of patients with category IIIB prostatitis(P>0.05). And, WBC count was not correlate to amount of LB in EPS of patients with category IV prostatitis(P>0.05).Conclusions:The levels of zinc and PSA in EPS are correlated to the severity of pain symptoms of patients with chronic nonbacterial prostatitis, and can be used to assess the severity and guide the treatment of chronic nonbacterial prostatitis. The amounts of WBC and LB are not reliable in assessing severity of chronic nonbacterial prostatitis.