Mizuno Taiki, Hiramatsu Ippei, Aoki Yusuke, Shimoyama Hirofumi, Nozaki Taiji, Shirai Masato, Lu Yan, Horie Shigeo, Tsujimura Akira
Department of Urology, Juntendo University Urayasu Hospital, Urayasu, Japan.
Department of Urology, Juntendo University Graduate School of Medicine, Tokyo, Japan.
Prostate Int. 2017 Sep;5(3):119-123. doi: 10.1016/j.prnil.2017.04.001. Epub 2017 Apr 12.
Chronic prostatitis (CP) significantly worsens a patient's quality of life (QOL), but its etiology is heterogeneous. Although the inflammatory process must be associated with CP symptoms, not all patients with benign prostatic hyperplasia and histological prostatitis complain of CP symptoms. The relation between the severity of histological inflammation and lower urinary tract symptoms (LUTS) and erectile function is not fully understood.
This study comprised 26 men with suspected prostate cancer but with no malignant lesion by pathological examination of prostate biopsy specimens. LUTS were assessed by several questionnaires including the International Prostate Symptom Score (IPSS), QOL index, Overactive Bladder Symptom Score (OABSS), and the National Institutes of Health-Chronic Prostatitis Symptom Index (NIH-CPSI), and erectile function was assessed by the Sexual Health Inventory for Men. Prostate volume (PV) measured by transabdominal ultrasound, maximum flow rate by uroflowmetry, and serum concentration of prostate-specific antigen were also evaluated. All data collections were performed before prostate biopsy. Histological prostatitis was assessed by immunohistochemical staining with anti-CD45 antibody as the Quick score. The relation between the Quick score and several factors was assessed by Pearson correlation coefficient and a multivariate linear regression model after adjustment for PV.
The Pearson correlation coefficient showed a correlation between the Quick score and several factors including PV, IPSS, QOL index, OABSS, and NIH-CPSI. A multivariate linear regression model after adjustment for PV showed only the NIH-CPSI to be associated with the Quick score. The relation between the Quick score and each domain score of the NIH-CPSI showed only the subscore of urinary symptoms to be an associated factor.
We found a correlation only between histological prostatitis and LUTS, but not erectile dysfunction. Especially, the subscore of urinary symptoms (residual feeling and urinary frequency) was associated with histological prostatitis.
慢性前列腺炎（CP）会显著恶化患者的生活质量（QOL），但其病因具有异质性。尽管炎症过程必定与CP症状相关，但并非所有良性前列腺增生和组织学前列腺炎患者都会抱怨有CP症状。组织学炎症的严重程度与下尿路症状（LUTS）及勃起功能之间的关系尚未完全明确。
本研究纳入了26名疑似前列腺癌但经前列腺活检标本病理检查未发现恶性病变的男性。通过包括国际前列腺症状评分（IPSS）、生活质量指数、膀胱过度活动症症状评分（OABSS）以及美国国立卫生研究院慢性前列腺炎症状指数（NIH-CPSI）等多项问卷对LUTS进行评估，通过男性性健康量表对勃起功能进行评估。还通过经腹超声测量前列腺体积（PV）、通过尿流率测定法测量最大尿流率，并评估前列腺特异性抗原的血清浓度。所有数据收集均在前列腺活检前进行。通过使用抗CD45抗体进行免疫组化染色作为快速评分来评估组织学前列腺炎。在对PV进行校正后，通过Pearson相关系数和多元线性回归模型评估快速评分与多个因素之间的关系。
Pearson相关系数显示快速评分与包括PV、IPSS、生活质量指数、OABSS和NIH-CPSI在内的多个因素之间存在相关性。对PV进行校正后的多元线性回归模型显示，仅NIH-CPSI与快速评分相关。快速评分与NIH-CPSI各领域评分之间的关系显示，仅尿路症状子评分是相关因素。
我们发现仅组织学前列腺炎与LUTS之间存在相关性，而与勃起功能障碍无关。特别是，尿路症状子评分（残余尿感和尿频）与组织学前列腺炎相关。
