The Arthur Smith Institute for Urology, North Shore Long Island Jewish Health System, New Hyde Park, New York.
Cancer. 2014 Jan 15;120(2):190-6. doi: 10.1002/cncr.28349. Epub 2013 Dec 9.
The current study was performed to evaluate whether baseline acute and chronic prostate inflammation among men with an initial negative biopsy for prostate cancer (PCa) increased the risk of subsequent PCa detection in a clinical trial with systematic biopsies.
A retrospective analysis was performed of 6238 men aged 50 years to 75 years with prostate-specific antigen levels between 2.5 ng/mL and 10 ng/mL and a prior negative biopsy in the REduction by DUtasteride of PCa Events study who completed a 2-year biopsy. PCa, acute prostate inflammation, and chronic prostate inflammation were assessed by central review. The association between inflammation in baseline prostate biopsies and positive 2-year and 4-year repeat biopsies was evaluated with the chi-square test and logistic regression analysis adjusting for baseline covariates.
Acute and chronic inflammation and both were detected in 46 baseline biopsies (1%), 3931 baseline biopsies (63%), and 892 baseline biopsies (14%), respectively. Acute and chronic inflammation were found to be significantly associated with each other (P<.001). Acute inflammation at baseline biopsy was associated with younger age, lower prostate-specific antigen levels, and a smaller prostate (all P<.01), whereas chronic inflammation was associated with older age and larger prostate glands (all P<0.01). At the 2-year biopsy, the prevalence of PCa was 14% (N=900 patients). On univariable and multivariable analysis, both acute and chronic inflammation were found to be significantly associated with a lower PCa risk (acute univariable: odds ratio [OR], 0.65 [P<.001] and multivariable: OR, 0.75 [P=.012] and chronic univariable: OR, 0.61 [P<.001] and multivariable: OR, 0.65 [P<.001]). At the time of 4-year biopsy, only acute inflammation was found to be associated with a lower PCa risk.
Baseline acute and chronic inflammation were both found to be independently associated with a lower PCa risk. From a clinical standpoint, inflammation in negative biopsies for PCa may lower the risk of subsequent PCa detection.
本研究旨在评估在一项接受系统性活检的临床试验中，患有前列腺癌（PCa）初始阴性活检的男性中，基线时急性和慢性前列腺炎症是否会增加随后 PCa 检测的风险。
对 6238 名年龄在 50 岁至 75 岁之间、前列腺特异性抗原（PSA）水平在 2.5ng/mL 至 10ng/mL 之间且之前进行过阴性 PCa 活检的男性进行了回顾性分析，这些患者完成了为期 2 年的活检。通过中央审查评估 PCa、急性前列腺炎症和慢性前列腺炎症。使用卡方检验和逻辑回归分析评估基线前列腺活检中的炎症与阳性 2 年和 4 年重复活检之间的关联，调整基线协变量。
46 例基线活检（1%）、3931 例基线活检（63%）和 892 例基线活检（14%）分别检测到急性和慢性炎症及两者均存在。基线活检时的急性和慢性炎症显著相关（P<0.001）。基线活检时的急性炎症与年龄较小、PSA 水平较低和前列腺较小有关（均 P<0.01），而慢性炎症与年龄较大和前列腺较大有关（均 P<0.01）。在 2 年活检时，PCa 的患病率为 14%（900 例患者）。在单变量和多变量分析中，急性和慢性炎症均与较低的 PCa 风险显著相关（急性单变量：优势比[OR]，0.65[P<0.001]和多变量：OR，0.75[P=0.012]和慢性单变量：OR，0.61[P<0.001]和多变量：OR，0.65[P<0.001]）。在 4 年活检时，只有急性炎症与较低的 PCa 风险相关。
基线时的急性和慢性炎症均与较低的 PCa 风险独立相关。从临床角度来看，PCa 阴性活检中的炎症可能会降低随后 PCa 检测的风险。
