Prostate chronic inflammation type IV and prostate cancer risk in patients undergoing first biopsy set: Results of a large cohort study
Antonio Benito Porcaroa, Giovanni Novellaa, Matteo Balzarroa, Guido Martignonib, Matteo Brunellib, Giovanni Cacciamania, Maria A. Cerrutoa, Walter Artibania
a Urologic Clinic, University Hospital, Ospedale Policlinico, Azienda Ospedaliera Universitaria Integrata, Verona, Italy; b Department of Pathology, University Hospital, Ospedale Policlinico, Azienda Ospedaliera Universitaria Integrata, Verona, Italy
Prostate chronic inflammation type IV and prostate cancer risk in patients undergoing first biopsy set: Results of a large cohort study
Antonio Benito Porcaroa, Giovanni Novellaa, Matteo Balzarroa, Guido Martignonib, Matteo Brunellib, Giovanni Cacciamania, Maria A. Cerrutoa, Walter Artibania
a Urologic Clinic, University Hospital, Ospedale Policlinico, Azienda Ospedaliera Universitaria Integrata, Verona, Italy; b Department of Pathology, University Hospital, Ospedale Policlinico, Azienda Ospedaliera Universitaria Integrata, Verona, Italy
摘要 Objective: In prostate specimens, chronic inflammatory infiltrate (CII) type IV has been detected, but its association with prostate cancer (PCa) is controversial. The aim of the present study is to investigate on associations of CII with PCa detection in patients undergoing prostate first biopsy set. Methods: Ultrasound transrectal-guided biopsies by the transperineal approach were retrospectively evaluated in 441 consecutive patients. The study excluded patients who were in active surveillance, prostate specific antigen (PSA)≥30 ng/mL, re-biopsies, incidental PCa after transurethral resection of the prostate (TURP), less than 14 cores or metastatic. Analysis of population and subpopulations (with or without PCa) was performed by statistical methods which included ManneWhitney (U test), Kruskal-Wallis test, Chi-squared statistic, logistic regression. Multivariate logistic regression models predicting mean probability of PCa detection were established. Results: PCa detection rate was 46.03%. Age, PSA, prostate volume (PV), prostate intraepithelial neoplasia (PIN) and CII were the significant independent predictors of PCa detection. PV (OR = 0.934) and CII (OR = 0.192) were both negative independent predictors. CII was a significant negative independent predictor in multivariate logistic regression models predicting the mean probability of PCa detection by age, PSA and PV. The inverse association of CII with PCa does not necessary mean protection because of PSA confounding.
Abstract: Objective: In prostate specimens, chronic inflammatory infiltrate (CII) type IV has been detected, but its association with prostate cancer (PCa) is controversial. The aim of the present study is to investigate on associations of CII with PCa detection in patients undergoing prostate first biopsy set. Methods: Ultrasound transrectal-guided biopsies by the transperineal approach were retrospectively evaluated in 441 consecutive patients. The study excluded patients who were in active surveillance, prostate specific antigen (PSA)≥30 ng/mL, re-biopsies, incidental PCa after transurethral resection of the prostate (TURP), less than 14 cores or metastatic. Analysis of population and subpopulations (with or without PCa) was performed by statistical methods which included ManneWhitney (U test), Kruskal-Wallis test, Chi-squared statistic, logistic regression. Multivariate logistic regression models predicting mean probability of PCa detection were established. Results: PCa detection rate was 46.03%. Age, PSA, prostate volume (PV), prostate intraepithelial neoplasia (PIN) and CII were the significant independent predictors of PCa detection. PV (OR = 0.934) and CII (OR = 0.192) were both negative independent predictors. CII was a significant negative independent predictor in multivariate logistic regression models predicting the mean probability of PCa detection by age, PSA and PV. The inverse association of CII with PCa does not necessary mean protection because of PSA confounding.
通讯作者:
Antonio Benito Porcaro
E-mail: drporcaro@yahoo.com
引用本文:
Antonio Benito Porcaro, Giovanni Novella, Matteo Balzarro, Guido Martignoni, Matteo Brunelli, Giovanni Cacciamani, Maria A. Cerruto, Walter Artibani. Prostate chronic inflammation type IV and prostate cancer risk in patients undergoing first biopsy set: Results of a large cohort study[J]. Asian Journal of Urology, 2015, 2(4): 224-232.
Antonio Benito Porcaro, Giovanni Novella, Matteo Balzarro, Guido Martignoni, Matteo Brunelli, Giovanni Cacciamani, Maria A. Cerruto, Walter Artibani. Prostate chronic inflammation type IV and prostate cancer risk in patients undergoing first biopsy set: Results of a large cohort study. Asian Journal of Urology, 2015, 2(4): 224-232.
Selman A. The McNeal prostate: a review. Urology 2011;78: 1224-8.
[2]
De Marzo AM, Platz EA, Sutcliffe S, Xu J, Grönberg H, Drake CG, et al. Inflammation in prostate carcinogenesis. Nat Rev Cancer 2007;7:256-69.
[3]
Sfanos KS, De Marzo AM. Prostate cancer and inflammation: the evidence. Histopathology 2012;60:199-215.
[4]
Bardia A, Platz EA, Yegnasubramanian S, De Marzo AM, Nelson WG. Anti-inflammatory drugs, antioxidants, and prostate cancer prevention. Curr Opin Pharmacol 2009;9:419-26.
[5]
Drake CG. Prostate cancer as a model for tumour immunotherapy. Nat Rev Immunol 2010;10:580-93.
[6]
Caruso C, Balistreri CR, Candore G, Carruba G, Colonna- Romano G, Di Bona D, et al. Polymorphisms of proinflammatory genes and prostate cancer risk: a pharmacogenomic approach. Cancer Immunol Immunother 2009;58: 1919-33.
[7]
Klein EA, Silverman R. Inflammation, infection, and prostate cancer. Curr Opin Urol 2008;18:315-9.
[8]
Nelson WG, De Marzo AM, Isaacs WB. Prostate cancer. N Engl J Med 2003;349:366-81.
[9]
Shook SJ, Beuten J, Torkko KC, Johnson-Pais TL, Troyer DA, Thompson IM, et al. Association of RNASEL variants with prostate cancer risk in Hispanic Caucasians and African Americans. Clin Cancer Res 2007;13:5959-64.
[10]
Wagenlehner FM, Elkahwaji JE, Algaba F, Bjerklund- Johansen T, Naber KG, Hartung R, et al. The role of inflammation and infection in the pathogenesis of prostatecarcinoma. BJU Int 2007;100:733-7.
[11]
Nelson JE, Harris RE. Inverse association of prostate cancer and non-steroidal anti-inflammatory drugs (NSAIDs): results of a case-control study. Oncol Rep 2000;7:169-70.
[12]
Montironi R, Mazzucchelli R, Pomante R, Thompson D, Duval da Silva V, Vaught L, et al. Immunohistochemical expression of pi class glutathione S-transferase in the basal cell layer of benign prostate tissue following chronic treatment with finasteride. J Clin Pathol 1999;52:350-4.
[13]
Coussens LM, Werb Z. Inflammation and cancer. Nature 2002; 420:860-7.
[14]
Mantovani A, Allavena P, Sica A, Balkwill F. Cancer related inflammation. Nature 2008;464:436-44.
[15]
Lin X, Asgari K, Putzi MJ, Gage WR, Yu X, Cornblatt BS, et al. Reversal of GSTP1 CpG island hypermethylation and reactivation of pi-class glutathione S-transferase (GSTP1) expression in human prostate cancer cells by treatment with procainamide. Cancer Res 2001;61:8611-6.
[16]
Fujita K, Ewing CM, Getzenberg RH, Parsons JK, Isaacs WB, Pavlovich CP. Monocyte chemotactic protein-1 (MCP-1/CCL2) is associated with prostatic growth dysregulation and benign prostatic hyperplasia. Prostate 2010;70:473-81.
[17]
König JE, Senge T, Allhoff EP, König W. Analysis of the inflammatory network in benign prostate hyperplasia and prostate cancer. Prostate 2004;58:121-9.
[18]
Barbisan F, Mazzucchelli R, Santinelli A, Lopez-Beltran A, Cheng L, Scarpelli M, et al. Overexpression of ELAV-like protein HuR is associated with increased COX-2 expression in atrophy, high-grade prostaticintraepithelial neoplasia, and incidental prostate cancer in cystoprostatectomies. Eur Urol 2009;56:105-12.
[19]
Palapattu GS, Sutcliffe S, Bastian PJ, Platz EA, De Marzo AM, Isaacs WB, et al. Prostate carcinogenesis and inflammation: emerging insights. Carcinogenesis 2005;26:1170-81.
[20]
Stock D, Groome PA, Siemens DR. Inflammation and prostate cancer: a future target for prevention and therapy? Urol Clin North Am 2008;35:117-30.
[21]
Di Silverio F, Bosman C, Salvatori M, Albanesi L, Proietti Pannunzi L, Ciccariello M, et al. Combination therapy with rofecoxib and finasteride in the treatment of men with lower urinary tract symptoms (LUTS) and benign prostatic hyperplasia (BPH). Eur Urol 2005;47:72-9.
[22]
Coffey DS. Similarities of prostate and breast cancer: evolution, diet, and estrogens. Urology 2001;57(4 Suppl. 1):31-8.
[23]
Rohrmann S, Nelson WG, Rifai N, Brown TR, Dobs A, Kanarek N, et al. Serum estrogen, but not testosterone, levels differ between black and white men in a nationally representative sample of Americans. J Clin Endocrinol Metab 2007; 92:2519-25.
[24]
Deroo BJ, Korach KS. Estrogen receptors and human disease. Clin Invest 2006;116:561-70.
[25]
Bosland MC. Sex steroids and prostate carcinogenesis: integrated, multifactorial working hypothesis. Ann N Y Acad Sci 2006;1089:168-76.
[26]
Prins GS, Korach KS. The role of estrogens and estrogen receptors in normal prostate growth and disease. Steroids 2008; 73:233-44.
[27]
Hsing AW, Sakoda LC, Chua Jr S. Obesity, metabolic syndrome, and prostate cancer. Am J Clin Nutr 2007;86:s843-57.
[28]
Murphy C, McGurk M, Pettigrew J, Santinelli A, Mazzucchelli R, Johnston PG, et al. Nonapical and cytoplasmic expression of interleukin-8, CXCR1, and CXCR2 correlates with cell proliferation and microvessel density in prostate cancer. Clin Cancer Res 2005;11:4117-27.
[29]
Jacobs EJ, Rodriguez C, Mondul AM, Connell CJ, Henley SJ, Calle EE, et al. A large cohort study of aspirin and other nonsteroidal anti-inflammatory drugs and prostate cancer incidence. J Natl Cancer Inst 2005;97(13):975-80.
[30]
Pruthi RS, Derksen JE, Moore D. A pilot study of use of the cyclooxygenase-2 inhibitor celecoxib in recurrent prostate cancer after definitive radiation therapy or radical prostatectomy. BJU Int 2004;93:275-8.
[31]
Di Silverio F, Sciarra A, Gentile V. Etoricoxib and intermittent androgen deprivation therapy in patients with biochemical progression after radical prostatectomy. Urology 2008;71: 947-51.
[32]
Kantoff PW, Higano CS, Shore ND, Berger ER, Small EJ, Penson DF, et al. IMPACT Study Investigators. Sipuleucel-T immunotherapy for castration-resistant prostate cancer. N Engl J Med 2010;363:411-22.
[33]
Krieger JN, Nyberg Jr L, Nickel JC. NIH consensus definition and classification of prostatitis. JAMA 1999;282:263-7.
[34]
De Marzo AM, Marchi VL, Epstein JI, Nelson WG. Proliferative inflammatory atrophy of the prostate: implications for prostatic carcinogenesis. Am J Pathol 1999;155:1985-92.
[35]
Blumenfeld W, Tucci S, Marayan P. Incidental lymphocytic prostatitis. Selective involvement with non malignant glands. Am J Surg Pathol 1992;16:975-81.
[36]
De Nunzio C, Kramer G, Marberger M, Montironi R, Nelson W, Schröder F, et al. The controversial relationship between benign prostatic hyperplasia and prostate cancer: the role of inflammation. Eur Urol 2011;60:106-17.
[37]
Gandaglia G, Briganti A, Gontero P, Mondaini N, Novara G, Salonia A, et al. The role of chronic inflammation in the pathogenesis and progression of benign prostatic hyperplasia (BPH). BJU Int 2013;112:432-41.
[38]
Porcaro AB, Novella G, Molinari A, Terrin A, Minja A, De Marco V, et al. Prostate volume index and chronic inflammation of the prostate type IV with respect to the risk of prostate cancer. Urol Int 2015;94:270-85.
[39]
Porcaro AB, Rubilotta E, Petrozziello A, Ghimenton C, Migliorini F, Zecchini Antoniolli S, et al. Chronic inflammation of the prostate type IV with respect to risk of prostate cancer. Arch Ital Urol Androl 2014;86:208-11.
[40]
Gerstenbluth RE, Seftel AD, Maclennan GT, Rao RN, Corty EW, Ferguson K, et al. Distribution of chronic prostatitis in radical prostatectomy specimens with up-regulation of bcl-2 in areas of inflammation. J Urol 2002;167:2267-70.
[41]
Irani J, Goujon JM, Ragni E, Peyrat L, Hubert J, Saint F, et al. High-grade inflammation in prostate as a prognostic factor for biochemical recurrence after radical prostatectomy. Pathologist Multi Center Study Group. Urology 1999; 54:467-72.
[42]
Karakiewicz PI, Benayoun S, Bégin LR, Duclos A, Valiquette L, McCormack M, et al. Chronic inflammation is negatively associated with prostate cancer and high-grade prostatic intraepithelial neoplasia on needle biopsy. Int J Clin Pract 2007;61:425-30.
[43]
Moreira DM, Nickel JC, Gerber L, Muller RL, Andriole GL, Castro-Santamaria R, et al. Baseline prostate inflammation is associated with a reduced risk of prostate cancer in men undergoing repeat prostate biopsy: results from the REDUCE study. Cancer 2014;120:190-6.
[44]
Zhang W, Sesterhenn IA, Connelly RR, Mostofi FK, Moul JW. Inflammatory infiltrate (prostatitis) in whole mounted radical prostatectomy specimens from black and white patients is not an etiology for radical difference in prostate specific antigen. J Urol 2000;163:131-6.
[45]
Roberts RO, Bergstralh EJ, Bass SE, Lieber M, Jacobsen SJ. Prostatitis as a risk factor for prostate cancer. Epidemiology 2004;15:93-9.
[46]
Davidsson S, Fiorentino M, Andrén O, Fang F, Mucci LA, Varenhorst E, et al. Inflammation, focal atrophic lesions, and prostatic intraepithelial neoplasia with respect to risk of lethal prostate cancer. Cancer Epidemiol Biomarkers Prev 2010; 20:2280-7.
[47]
Engelhardt PF, Brustmann H, Seklehner S, Riedl CR. Chronic asymptomatic inflammation of the prostate type IV and carcinoma of the prostate: is there a correlation? Scand J Urol 2013;47:230-5.
[48]
Hammerstrom AE, Cauley DH, Atkinson BJ, Sharma P. Cancer Immunotherapy: sipuleucel-T and beyond. Pharmacotherapy 2011;31:813-28.
[49]
Brennen WN, Denmeade SR, Isaacs JT. Mesenchymal stem cells as a vector for the inflammatory prostate microenvironment. Endocr Relat Cancer 2013;20:R269-90.
[50]
Nguyen DP, Li J, Tewari AK. Inflammation and prostate cancer: the role of interleukin 6 (IL-6). BJU Int 2014;113:986-92.
[51]
Roobol MJ, Schroder FH, Hugosson J, Jones JS, Kattan MW, Klein EA, et al. Importance of prostate volume in the European Randomised Study of Screening for Prostate Cancer (ERSPC) risk calculators: results from the prostate biopsy collaborative group. World J Urol 2012;30:149-55.
[52]
Al-Azab R, Toi A, Lockwood G, Kulkarni GS, Fleshner N. Prostate volume is strongest predictor of cancer diagnosis at transrectal ultrasound-guided prostate biopsy with prostatespecific antigen values between 2.0 and 9.0 ng/mL. Urology 2007;69:103-7.
[53]
Hoekx L, Jeuris W, Van Marck E, Wyndaele JJ. Elevated serum prostate specific antigen (PSA) related to asymptomatic prostatic inflammation. Acta Urol Bel 1998;66: 1-2.
[54]
Sindhwani P, Wilson CM. Prostatitis and serum prostatespecific antigen. Curr Urol Rep 2005;6:306-12.
[55]
Hochreiter WW. The issue of elevated prostate cancer evaluation in men with elevated prostate-specific antigen and chronic prostatitis. Andrologia 2008;40:130-3.
Christopher Hartman, Nikhil Gupta, David Leavitt, David Hoenig, Zeph Okeke, Arthur Smith. Advances in percutaneous stone surgery[J]. Asian Journal of Urology, 2015, 2(1): 26
-32
.
