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Chronic inflammation of the prostate type IV with respect to risk of prostate cancer

Antonio B. Porcaro, Emanuele Rubilotta, Aldo Petrozziello, Claudio Ghimenton, Filippo Migliorini, Stefano Zecchini Antoniolli, Vincenzo Lacola, Carmelo Monaco, Pierpaolo Curti, Stefano Cavalleri, Romeo Pianon, Walter Artibani
  • Antonio B. Porcaro
    Urologic Clinic, University Hospitals, Ospedale Policlinico and Ospedale Civile Maggiore, Azienda Ospedaliera Universitaria Integrata, Verona, Italy | drporcaro@yahoo.com
  • Emanuele Rubilotta
    Urologic Clinic, University Hospitals, Ospedale Policlinico and Ospedale Civile Maggiore, Azienda Ospedaliera Universitaria Integrata, Verona, Italy
  • Aldo Petrozziello
    Geriatric Medicine/Endocrinology, University Hospitals, Ospedale Policlinico and Ospedale Civile Maggiore, Azienda Ospedaliera Universitaria Integrata, Verona, Italy
  • Claudio Ghimenton
    Pathology, University Hospitals, Ospedale Policlinico and Ospedale Civile Maggiore, Azienda Ospedaliera Universitaria Integrata, Verona, Italy
  • Filippo Migliorini
    Urologic Clinic, University Hospitals, Ospedale Policlinico and Ospedale Civile Maggiore, Azienda Ospedaliera Universitaria Integrata, Verona, Italy
  • Stefano Zecchini Antoniolli
    Urologic Clinic, University Hospitals, Ospedale Policlinico and Ospedale Civile Maggiore, Azienda Ospedaliera Universitaria Integrata, Verona, Italy
  • Vincenzo Lacola
    Urologic Clinic, University Hospitals, Ospedale Policlinico and Ospedale Civile Maggiore, Azienda Ospedaliera Universitaria Integrata, Verona, Italy
  • Carmelo Monaco
    Urologic Clinic, University Hospitals, Ospedale Policlinico and Ospedale Civile Maggiore, Azienda Ospedaliera Universitaria Integrata, Verona, Italy
  • Pierpaolo Curti
    Urologic Clinic, University Hospitals, Ospedale Policlinico and Ospedale Civile Maggiore, Azienda Ospedaliera Universitaria Integrata, Verona, Italy
  • Stefano Cavalleri
    Urologic Clinic, University Hospitals, Ospedale Policlinico and Ospedale Civile Maggiore, Azienda Ospedaliera Universitaria Integrata, Verona, Italy
  • Romeo Pianon
    Urologic Clinic, University Hospitals, Ospedale Policlinico and Ospedale Civile Maggiore, Azienda Ospedaliera Universitaria Integrata, Verona, Italy
  • Walter Artibani
    Urologic Clinic, University Hospitals, Ospedale Policlinico and Ospedale Civile Maggiore, Azienda Ospedaliera Universitaria Integrata, Verona, Italy

Abstract

Background: Chronic inflammatory infiltrate (CII) might be involved in prostate cancer (PCA) and benign hyperplasia (BPH); however, its significance is controversial. Chronic inflammatory prostatitis type IV is the most common non cancer diagnosis in men undergoing biopsy because of suspected PCA. Objective: To evaluate potential associations of coexistent CII and PCA in biopsy specimens after prostate assessment. Design, setting, and participants: Between January 2007 and December 2008, 415 consecutive patients who underwent prostate biopsy were retrospectively evaluated. The investigated variables included Age (years) and PSA (ug/l); moreover, CII+, glandular atrophy (GA+), glandular hyperplasia (GH+), prostate Intraepithelial neoplasm (PIN+), atypical small acinar cell proliferation (ASAP+) and PCA positive cores (P+) were evaluated as categorical and continuous (proportion of positive cores). Outcome measurements and statistical analysis: Associations of CII+ and PCA risk were assessed by statistical methods. Results and limitations: In the patient population, a biopsy core positive for PCA was detected in 34.2% of cases and the rate of high grade PCA (HGPCA: bGS ! 8) resulted 4.82%. CII+ significantly and inversely associated with a positive biopsy core P+ (P < 0.0001; OR = 0.26) and HGPCA (P = 0.0005; OR = 0.05). Moreover, the associations indicated that patients with coexistent CII+ on needle biopsy were 74% less likely to have coexistent PCA than men without CII+ as well as 95% less likely to have HGPCA in the biopsy core than men without coexistent CII+. There were limits in our study which was single centre and included only one dedicated pathologist. Conclusions: There was an inverse association of chronic inflammation of the prostate type IV and risk of PCA; moreover, HGPCA was less likely to be detected in cancers associated with coexistent CII. In prostate microenvironment, prostate chronic inflammation may be protective; however, its role in PCA carcinogenesis remains controversial and needs further research.

Keywords

Prostate; Prostate cancer; Prostate-specific antigen; Prostate biopsy; Chronic inflammation; Biopsy Gleason score

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Submitted: 2014-10-10 10:59:43
Published: 2014-09-30 00:00:00
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Copyright (c) 2014 Antonio B. Porcaro, Emanuele Rubilotta, Aldo Petrozziello, Claudio Ghimenton, Filippo Migliorini, Stefano Zecchini Antoniolli, Vincenzo Lacola, Carmelo Monaco, Pierpaolo Curti, Stefano Cavalleri, Romeo Pianon, Walter Artibani

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