Engelhardt P F, Brustmann H, Seklehner S, Riedl C R
Department of Urology and Andrology, Landesklinikum Thermenregion Baden, Austria.
Scand J Urol. 2013 Jun;47(3):230-5. doi: 10.3109/00365599.2012.733961. Epub 2012 Oct 22.
The aim of this study was to detect possible correlations between chronic asymptomatic inflammation of the prostate type IV and prostate cancer in patients undergoing radical prostatectomy (RPE).
Between January and December 2010, 57 RPE specimens were prospectively evaluated with regard to histological signs of chronic inflammation. This RPE group was compared to specimens of 82 men undergoing transurethral resection of the prostate (TURP) or transvesical enucleation (TVE) of a benign prostate (BPH group). To characterize inflammatory changes, inflammatory "hot spots" were defined according to the histological criteria of Irani et al. (J Urol 1997;157:1301-3). Total prostate-specific antigen (PSA), cholesterol, triglycerides, uric acid, International Prostate Symptom Score and body mass index (BMI) were evaluated preoperatively and were correlated to the histological findings.
Chronic inflammation was verified in 43.86% of the RPE group, compared to 70.74% of the BPH group (p < 0.001). Multivariate analysis found a significant correlation between older patients and the inflammation score (p < 0.03) and prostate volume (p < 0.03). There was no difference in the PSA values between the inflammation and non-inflammation groups: mean PSA was 5.7 vs 6.1 ng/ml in the RPE group (p < 0.89), and 2.8 vs 2.9 ng/ml in the BPH group (p < 0.94). Gleason score distribution (5-9) and tumour stage (TNM) were similar in the inflammation and non-inflammation groups (p < 0.99, p < 0.21).
No significant correlation between chronic prostatic inflammation and carcinoma of the prostate was detected. Contrary to expectations, a significantly higher score of inflammatory changes was found in BPH patients; also, total PSA levels were lower in the inflammation group.
本研究旨在检测接受根治性前列腺切除术(RPE)患者的IV型前列腺慢性无症状炎症与前列腺癌之间可能存在的相关性。
2010年1月至12月期间,对57份RPE标本进行了慢性炎症组织学征象的前瞻性评估。将该RPE组与82例行前列腺良性增生经尿道前列腺切除术(TURP)或经膀胱摘除术(TVE)的男性患者标本(BPH组)进行比较。为了描述炎症变化,根据Irani等人的组织学标准(《泌尿外科杂志》1997年;157:1301 - 3)定义炎症“热点”。术前评估总前列腺特异性抗原(PSA)、胆固醇、甘油三酯、尿酸、国际前列腺症状评分和体重指数(BMI),并将其与组织学结果相关联。
RPE组中43.86%证实存在慢性炎症,而BPH组为70.74%(p < 0.001)。多因素分析发现老年患者与炎症评分(p < 0.03)和前列腺体积(p < 0.03)之间存在显著相关性。炎症组和非炎症组的PSA值无差异:RPE组平均PSA分别为5.7和6.1 ng/ml(p < 0.89),BPH组分别为2.8和2.9 ng/ml(p < 0.94)。炎症组和非炎症组的Gleason评分分布(5 - 9)和肿瘤分期(TNM)相似(p < 0.99,p < 0.21)。
未检测到慢性前列腺炎症与前列腺癌之间存在显著相关性。与预期相反,BPH患者的炎症变化评分显著更高;此外,炎症组的总PSA水平更低。