Boehm Katharina, Valdivieso Roger, Meskawi Malek, Larcher Alessandro, Schiffmann Jonas, Sun Maxine, Graefen Markus, Saad Fred, Parent Marie-Élise, Karakiewicz Pierre I
Martini-Klinik am Universitätsklinikum Hamburg-Eppendorf, Hamburg, Germany.
Cancer Prognostics and Health Outcomes Unit, University of Montreal Health Center, Montreal, Canada.
World J Urol. 2016 Mar;34(3):425-30. doi: 10.1007/s00345-015-1625-1. Epub 2015 Jun 25.
We relied on a population-based case-control study (PROtEuS) to examine a potential association between the presence of histologically confirmed prostate cancer (PCa) and history of genitourinary infections, e.g., prostatitis, urethritis, orchitis and epididymitis.
Cases were 1933 men with incident PCa, diagnosed across Montreal hospitals between 2005 and 2009. Population controls were 1994 men from the same residential area and age distribution. In-person interviews collected information about socio-demographic characteristics, lifestyle and medical history, e.g., self-reported history of several genitourinary infections, as well as on PCa screening. Logistic regression analyses tested overall and grade-specific associations, including subgroup analyses with frequent PSA testing.
After multivariable adjustment, prostatitis was associated with an increased risk of any PCa (OR 1.81 [1.44-2.27]), but not urethritis (OR 1.05 [0.84-1.30]), orchitis (OR 1.28 [0.92-1.78]) or epididymitis (OR 0.98 [0.57-1.68]). The association between prostatitis and PCa was more pronounced for low-grade PCa (Gleason ≤ 6: OR 2.11 [1.61-2.77]; Gleason ≥ 7: OR 1.59 [1.22-2.07]). Adjusting for frequency of physician visits, PSA testing frequency or restricting analyses to frequently screened subjects did not affect these results.
Prostatitis was associated with an increased probability for detecting PCa even after adjustment for frequency of PSA testing and physician visits, but not urethritis, orchitis or epididymitis. These considerations may be helpful in clinical risk stratification of individuals in whom the risk of PCa is pertinent.
我们依托一项基于人群的病例对照研究（PROtEuS），来检验经组织学确诊的前列腺癌（PCa）的存在与泌尿生殖系统感染病史（如前列腺炎、尿道炎、睾丸炎和附睾炎）之间的潜在关联。
病例为1933例新发PCa男性患者，于2005年至2009年期间在蒙特利尔各医院确诊。人群对照为来自同一居住区域且年龄分布相同的1994名男性。通过面对面访谈收集社会人口学特征、生活方式和病史信息，如自我报告的几种泌尿生殖系统感染病史，以及PCa筛查情况。逻辑回归分析检验总体关联和分级特异性关联，包括进行频繁PSA检测的亚组分析。
经过多变量调整后，前列腺炎与任何PCa风险增加相关（比值比[OR]为1.81[1.44 - 2.27]），但尿道炎（OR为1.05[0.84 - 1.30]）、睾丸炎（OR为1.28[0.92 - 1.78]）或附睾炎（OR为0.98[0.57 - 1.68]）并非如此。前列腺炎与PCa之间的关联在低级别PCa中更为明显（Gleason评分≤6：OR为2.11[1.61 - 2.77]；Gleason评分≥7：OR为1.59[1.22 - 2.07]）。调整医生就诊频率、PSA检测频率或仅对频繁筛查的受试者进行分析，均不影响这些结果。
即使在调整PSA检测频率和医生就诊频率后，前列腺炎仍与检测到PCa的概率增加相关，但尿道炎、睾丸炎或附睾炎并非如此。这些考量可能有助于对PCa风险相关个体进行临床风险分层。
