The presence of chronic inflammation in positive prostate biopsy is associated with upgrading in radical prostatectomy
https://doi.org/10.4081/aiua.2021.3.280
Accepted: May 7, 2021
All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.
Objective: This study aimed to determine the predictive effect of the presence of chronic prostatitis associated with prostate cancer (PCa) in prostate biopsy on Gleason score upgrade (GSU) in radical prostatectomy (RP) specimens.
Materials and methods: The data of 295 patients who underwent open or robotic RP with a diagnosis of localized PCa following biopsy were retrospectively analyzed. Patients were divided into two groups with and without GSU following RP. Predictive factors affecting GSU on biopsy were determined. The impact of chronic prostatitis associated with prostate cancer on GSU was examined via logistic regression analysis.
Results: Out of 224 patients with Gleason 3+3 scores on biopsy, 145 (64.7%) had Gleason upgrade, and 79 (35.2%) had no upgrade. Whilst comparing the two groups with and without Gleason upgrade in terms of patient age, prostate-specific antigen (PSA) value, PSA density (PSAD), prostate volume (PV), neutrophil/lymphocyte (N/L) ratio, number of positive cores, percentage of positive cores, and Prostate Imaging Reporting and Data System version 2 score, no statistically significant difference was detected. The presence of chronic prostatitis associated with PCa was higher in the patient cohort with GSU in contrast to the other group (p < 0.001). According to the univariate logistic regression analysis, the presence of chronic prostatitis was identified to be an independent marker for GSU.
Conclusions: Pathologists and urologists should be careful regarding the possibility of a more aggressive tumor in the presence of chronic inflammation associated with PCa because inflammation within PCa was revealed to be linked with GSU after RP.
Cai T, Santi R, Tamanini I, et al. Current knowledge of the potential links between inflammation and prostate cancer. Int J Mol Sci. 2019; 20:3833. DOI: https://doi.org/10.3390/ijms20153833
Jiang J, Li J, Yunxia Z, et al. The role of prostatitis in prostate cancer: meta-analysis. PloS one. 2013; 8:e85179. DOI: https://doi.org/10.1371/journal.pone.0085179
Sfanos KS, Yegnasubramanian S, Nelson WG, De Marzo AM. The inflammatory microenvironment and microbiome in prostate cancer development. Nat Rev Urol. 2018; 15:11-24. DOI: https://doi.org/10.1038/nrurol.2017.167
Puhr M, De Marzo A, Isaacs W, et al. Inflammation, microbiota, and prostate cancer. Eur Urol Focus. 2016; 2:374-82. DOI: https://doi.org/10.1016/j.euf.2016.08.010
Cheng I, Witte JS, Jacobsen SJ, et al. Prostatitis, sexually transmitted diseases, and prostate cancer: the California Men's Health Study. PLoS One. 2010; 5:e8736. DOI: https://doi.org/10.1371/journal.pone.0008736
Neveu B, Moreel X, Deschênes-Rompré M-P, et al. IL-8 secretion in primary cultures of prostate cells is associated with prostate cancer aggressiveness. Res Rep Urol. 2014; 6:27. DOI: https://doi.org/10.2147/RRU.S58643
Araki S, Omori Y, Lyn D, et al. Interleukin-8 is a molecular determinant of androgen independence and progression in prostate cancer. Cancer Res. 2007; 67:6854-62. DOI: https://doi.org/10.1158/0008-5472.CAN-07-1162
Nguyen DP, Li J, Tewari AK. Inflammation and prostate cancer: the role of interleukin 6 (IL-6). BJU International. 2014; 113:986-92. DOI: https://doi.org/10.1111/bju.12452
Alchin DR, Murphy D, Lawrentschuk N. Risk factors for Gleason Score upgrading following radical prostatectomy. Minerva Urol Nefrol. 2017; 69:459-65. DOI: https://doi.org/10.23736/S0393-2249.16.02684-9
Dinh KT, Mahal BA, Ziehr DR, et al. Incidence and predictors of upgrading and up staging among 10,000 contemporary patients with low risk prostate cancer. J Urol. 2014; 194:343-9. DOI: https://doi.org/10.1016/j.juro.2015.02.015
Moussa AS, Li J, Soriano M, et al. Prostate biopsy clinical and pathological variables that predict significant grading changes in patients with intermediate and high grade prostate cancer. BJU international. 2009; 103:43-8. DOI: https://doi.org/10.1111/j.1464-410X.2008.08059.x
Doat S, Cénée S, Trétarre B, et al. Nonsteroidal anti-inflammatory drugs (NSAID s) and prostate cancer risk: results from the EPICAP study. Cancer Med. 2017; 6:2461-70. DOI: https://doi.org/10.1002/cam4.1186
Nickel JC, True LD, Krieger JN, et al. Consensus development of a histopathological classification system for chronic prostatic inflammation. BJU International. 2001; 87:797-805. DOI: https://doi.org/10.1046/j.1464-410x.2001.02193.x
Clemens JQ, Meenan RT, Rosetti MCK, Kimes T, Calhoun EA. Prevalence of and risk factors for prostatitis: population based assessment using physician assigned diagnoses. J Urol. 2007; 178:1333-7. DOI: https://doi.org/10.1016/j.juro.2007.05.140
Teke K, Danacıoglu YO, Polat S. Predictive parameters on the effect of ofloxacin treatment on the reduction of PSA in patients with elevated PSA level. Yeni Üroloji Dergisi - The New Journal of Urology. 2019; 14:166-75.
Polackwich A, Shoskes D. Chronic prostatitis/chronic pelvic pain syndrome: a review of evaluation and therapy. Prostate Cancer Prostatic Dis. 2016; 19:132. DOI: https://doi.org/10.1038/pcan.2016.8
Potts JM. Prospective identification of National Institutes of Health category IV prostatitis in men with elevated prostate specific antigen. J Urol. 2000; 164:1550-3. DOI: https://doi.org/10.1016/S0022-5347(05)67026-7
Carver BS, Bozeman CB, Williams B, Venable DD. The prevalence of men with National Institutes of Health category IV prostatitis and association with serum prostate specific antigen. J Urol. 2003;169:589-91. DOI: https://doi.org/10.1016/S0022-5347(05)63959-6
Nguyen DP, Li J, Yadav SS, Tewari AK. Recent insights into NF-κB signalling pathways and the link between inflammation and prostate cancer. BJU International. 2014; 114:168-76. DOI: https://doi.org/10.1111/bju.12488
Sorrentino C, Ciummo SL, Cipollone G, et al. Interleukin-30/IL27p28 shapes prostate cancer stem-like cell behavior and is critical for tumor onset and metastasization. Cancer Res. 2018; 78:2654-68. DOI: https://doi.org/10.1158/0008-5472.CAN-17-3117
Liu Y, Mo JQ, Hu Q, et al. Targeted overexpression of vav3 oncogene in prostatic epithelium induces nonbacterial prostatitis and prostate cancer. Cancer Res 2008; 68:6396-406. DOI: https://doi.org/10.1158/0008-5472.CAN-08-0645
Perletti G, Monti E, Magri V, et al. The association between prostatitis and prostate cancer. Systematic review and meta-analysis. Arch Ital Urol Androl. 2017; 89:259-65. DOI: https://doi.org/10.4081/aiua.2017.4.259
Jafari S, Etminan M, Afshar K. Nonsteroidal anti-inflammatory drugs and prostate cancer: a systematic review of the literature and meta-analysis. Can Urol Ass J. 2009; 3:323. DOI: https://doi.org/10.5489/cuaj.1129
Delongchamps NB, De La Roza G, Chandan V, et al. Evaluation of prostatitis in autopsied prostates—is chronic inflammation more associated with benign prostatic hyperplasia or cancer? J Urol. 2008;179:1736-40. DOI: https://doi.org/10.1016/j.juro.2008.01.034
Klink JC, Bañez LL, Gerber L, et al. Intratumoral inflammation is associated with more aggressive prostate cancer. World J Urol. 2013; 31:1497-503. DOI: https://doi.org/10.1007/s00345-013-1065-8
McArdle P, Canna K, McMillan D, et al. The relationship between T-lymphocyte subset infiltration and survival in patients with prostate cancer. Br J Cancer. 2004; 91:541. DOI: https://doi.org/10.1038/sj.bjc.6601943
Özsoy M, Moschini M, Fajkovic H, et al. Elevated preoperative neutrophil-lymphocyte ratio predicts upgrading at radical prostatectomy. Prostate Cancer Prostatic Dis. 2018; 21:100. DOI: https://doi.org/10.1038/s41391-017-0015-8
Porcaro AB, Siracusano S, de Luyk N, et al. Low-risk prostate cancer and tumor upgrading in the surgical specimen: analysis of clinical factors predicting tumor upgrading in a contemporary series of patients who were evaluated according to the modified Gleason score grading system. Curr Urol. 2017; 10:118-125. DOI: https://doi.org/10.1159/000447164
Gurel B, Lucia MS, Thompson IM Jr, et al. Chronic inflammation in benign prostate tissue is associated with high-grade prostate cancer in the placebo arm of the prostate cancer prevention trial. Cancer Epidemiol Biomarkers Prev. 2014; 23:847-56. DOI: https://doi.org/10.1158/1055-9965.EPI-13-1126
PAGEPress has chosen to apply the Creative Commons Attribution NonCommercial 4.0 International License (CC BY-NC 4.0) to all manuscripts to be published.
Downloads
Citations
