Charles University in Prague, 3rd Faculty of Medicine, Department of Urology, Prague, Czech Republic.
BMC Cancer. 2011 Feb 3;11:53. doi: 10.1186/1471-2407-11-53.
Infection plays a role in the pathogenesis of many human malignancies. Whether prostate cancer (PCa) - an important health issue in the aging male population in the Western world - belongs to these conditions has been a matter of research since the 1970 s. Persistent serum antibodies are a proof of present or past infection. The aim of this study was to compare serum antibodies against genitourinary infectious agents between PCa patients and controls with benign prostate hyperplasia (BPH). We hypothesized that elevated serum antibody levels or higher seroprevalence in PCa patients would suggest an association of genitourinary infection in patient history and elevated PCa risk.
A total of 434 males who had undergone open prostate surgery in a single institution were included in the study: 329 PCa patients and 105 controls with BPH. The subjects' serum samples were analysed by means of enzyme-linked immunosorbent assay, complement fixation test and indirect immunofluorescence for the presence of antibodies against common genitourinary infectious agents: human papillomavirus (HPV) 6, 11, 16, 18, 31 and 33, herpes simplex virus (HSV) 1 and 2, human cytomegalovirus (CMV), Chlamydia trachomatis, Mycoplasma hominis, Ureaplasma urealyticum, Neisseria gonorrhoeae and Treponema pallidum. Antibody seroprevalence and mean serum antibody levels were compared between cases and controls. Tumour grade and stage were correlated with serological findings.
PCa patients were more likely to harbour antibodies against Ureaplasma urealyticum (odds ratio (OR) 2.06; 95% confidence interval (CI) 1.08-4.28). Men with BPH were more often seropositive for HPV 18 and Chlamydia trachomatis (OR 0.23; 95% CI 0.09-0.61 and OR 0.45; 95% CI 0.21-0.99, respectively) and had higher mean serum CMV antibody levels than PCa patients (p = 0.0004). Among PCa patients, antibodies against HPV 6 were associated with a higher Gleason score (p = 0.0305).
Antibody seropositivity against the analyzed pathogens with the exception of Ureaplasma does not seem to be a risk factor for PCa pathogenesis. The presence or higher levels of serum antibodies against the genitourinary pathogens studied were not consistently associated with PCa. Serostatus was not a predictor of disease stage in the studied population.
感染在许多人类恶性肿瘤的发病机制中起作用。自 20 世纪 70 年代以来，前列腺癌（PCa）——西方老年男性人群中的一个重要健康问题——是否属于此类疾病一直是研究的课题。持续存在的血清抗体是目前或过去感染的证据。本研究旨在比较 PCa 患者和良性前列腺增生（BPH）患者的泌尿生殖道感染病原体血清抗体。我们假设 PCa 患者血清抗体水平升高或血清阳性率升高表明患者病史中有泌尿生殖道感染，并提示 PCa 风险增加。
本研究共纳入 434 名在单一机构接受开放性前列腺手术的男性：329 名 PCa 患者和 105 名 BPH 对照组。通过酶联免疫吸附试验、补体固定试验和间接免疫荧光法分析受试者血清样本，检测常见泌尿生殖道感染病原体的抗体：人乳头瘤病毒（HPV）6、11、16、18、31 和 33、单纯疱疹病毒（HSV）1 和 2、人巨细胞病毒（CMV）、沙眼衣原体、解脲支原体、淋病奈瑟菌和梅毒螺旋体。比较病例组和对照组的抗体血清阳性率和平均血清抗体水平。肿瘤分级和分期与血清学发现相关。
PCa 患者更有可能携带解脲支原体抗体（比值比（OR）2.06；95%置信区间（CI）1.08-4.28）。BPH 患者对 HPV 18 和沙眼衣原体的血清阳性率更高（OR 0.23；95%CI 0.09-0.61 和 OR 0.45；95%CI 0.21-0.99），CMV 血清抗体水平也高于 PCa 患者（p = 0.0004）。在 PCa 患者中，HPV 6 抗体与较高的 Gleason 评分相关（p = 0.0305）。
除解脲支原体外，分析病原体的抗体血清阳性率似乎不是 PCa 发病机制的危险因素。研究中泌尿生殖道病原体的存在或更高水平的血清抗体与 PCa 并不一致相关。在研究人群中，血清学状态不是疾病分期的预测因子。
