Platz Elizabeth A, De Marzo Angelo M
Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, The Brady Urological Institute, The Sidney Kimmel Comprehensive Cancer Center, Baltimore, Maryland 21205, USA.
J Urol. 2004 Feb;171(2 Pt 2):S36-40. doi: 10.1097/01.ju.0000108131.43160.77.
We provide an overview of some of the basic, clinical and epidemiological research that has been conducted to investigate the potential role of chronic inflammation in prostate carcinogenesis and to provide direction for future research on this hypothesis.
We reviewed the literature on this topic.
Chronic inflammation has long been linked to cancers with an infectious etiology, such as stomach, liver and colon cancer, in patients with inflammatory bowel disease. Whether intraprostatic inflammation contributes to prostate carcinogenesis is unknown. Inflammation is frequently present in prostate biopsies, radical prostatectomy specimens and tissue resected for treatment of benign prostatic hyperplasia. Also, inflammatory infiltrates are often found in and around foci of atrophy that are characterized by an increased proliferative index. These foci, called proliferative inflammatory atrophy, may be precursors of early prostate cancer or may indicate an intraprostatic environment favorable to cancer development. Epidemiological studies have indirectly examined the role of chronic inflammation in prostate carcinogenesis through studies of pro-inflammatory and anti-inflammatory factors. When taken together studies of sexually transmitted infections, clinical prostatitis, and genetic and circulating markers of inflammation and response to infection hint at a link between chronic intraprostatic inflammation and prostate cancer.
Additional well-designed basic, clinical and epidemiological studies are needed to resolve questions about the role of chronic inflammation in prostate carcinogenesis and to determine if intraprostatic inflammation is a rational target for chemoprevention.
我们概述了一些基础、临床和流行病学研究，这些研究旨在探究慢性炎症在前列腺癌发生过程中的潜在作用，并为基于该假说的未来研究提供方向。
我们回顾了关于该主题的文献。
长期以来，慢性炎症一直与炎症性肠病患者中由感染病因引起的癌症相关，如胃癌、肝癌和结肠癌。前列腺内炎症是否会促进前列腺癌的发生尚不清楚。炎症在前列腺活检组织、根治性前列腺切除术标本以及因良性前列腺增生而切除的组织中经常出现。此外，在以增殖指数增加为特征的萎缩灶及其周围也经常发现炎性浸润。这些病灶称为增殖性炎性萎缩，可能是早期前列腺癌的前体，或者可能表明前列腺内环境有利于癌症发展。流行病学研究通过对促炎和抗炎因子的研究间接考察了慢性炎症在前列腺癌发生中的作用。综合来看，关于性传播感染、临床前列腺炎以及炎症和感染反应的遗传及循环标志物的研究暗示了慢性前列腺内炎症与前列腺癌之间的联系。
需要更多设计良好的基础、临床和流行病学研究来解决关于慢性炎症在前列腺癌发生中的作用的问题，并确定前列腺内炎症是否是化学预防的合理靶点。
