Department of Urology, University of Verona, Azienda Ospedaliera Universitaria Integrata Verona, Verona, Italy.
Divisione Clinicizzata di Urologia, Dipartimento ad Attività Integrata di Chirurgia ed Oncologia - Pancreas Center, University of Verona, Policlinico GB Rossi, P.le LA Scuro, 10, 37134, Verona, Italy.
World J Urol. 2020 Apr;38(4):957-964. doi: 10.1007/s00345-019-02830-7. Epub 2019 Jun 1.
To assess associations of prostate volume index (PVI), defined as the ratio of the volume of the central transition zone to the volume of the peripheral zone of the prostate and prostatic chronic inflammation (PCI) as predictors of tumor load by number of positive cores (PC) in patients undergoing baseline random biopsies.
Parameters evaluated included age, PSA, total prostate volume, PSA density, digital rectal exam, PVI, and PCI. All patients underwent standard transperineal random biopsies. Tumor load was evaluated as absent (no PC), limited (1-3 PC), and extensive (more than 3 PC). The association of factors with the risk of tumor load was evaluated by the multinomial logistic regression model.
The study evaluated 945 patients. Cancer PC were detected in 477 (507%) cases of whom 207 (43.4%) had limited tumor load and 270 (56.6%) had extensive tumor load. Among other factors, comparing patients with limited tumor load with negative cases, PVI [odds ratio, OR = 0.521, 95% confidence interval (CI) 0.330-0.824; p < 0.005] and PCI (OR = 0.289, 95% CI 0.180-0.466; p < 0.0001) were inversely associated with the PCA risk. Comparing patients with extensive tumor load with negative patients, PVI (OR = 0.579, 95% CI 0.356-0.944; p = 0.028), and PCI (OR = 0.150, 95% CI 0.085-0.265; p < 0.0001), predicted PCA risk. Comparing extensive tumor load with limited tumor load patients, PVI and PCI did not show any association with the tumor load.
Increased PVI and the presence of PCI decreased the risk of increased tumor load and associated with less aggressive prostate cancer biology in patients at baseline random biopsies.
评估前列腺体积指数（PVI）与前列腺慢性炎症（PCI）作为预测基线随机活检患者肿瘤负荷的指标，以确定肿瘤负荷的预测价值。方法：评估的参数包括年龄、PSA、前列腺总体积、PSA 密度、直肠指诊、PVI 和 PCI。所有患者均接受标准经会阴随机活检。肿瘤负荷评估为无（无 PC）、有限（1-3 个 PC）和广泛（超过 3 个 PC）。采用多项逻辑回归模型评估各因素与肿瘤负荷风险的关系。结果：该研究共评估了 945 例患者。477 例（50.7%）患者检出癌 PC，其中 207 例（43.4%）为局限性肿瘤负荷，270 例（56.6%）为广泛性肿瘤负荷。除其他因素外，与阴性病例相比，局限性肿瘤负荷患者的 PVI[比值比（OR）=0.521，95%置信区间（CI）0.330-0.824；p<0.005]和 PCI（OR=0.289，95%CI 0.180-0.466；p<0.0001）与 PCA 风险呈负相关。与阴性患者相比，广泛性肿瘤负荷患者的 PVI（OR=0.579，95%CI 0.356-0.944；p=0.028）和 PCI（OR=0.150，95%CI 0.085-0.265；p<0.0001）预测 PCA 风险。与局限性肿瘤负荷患者相比，广泛性肿瘤负荷患者的 PVI 和 PCI 与肿瘤负荷无明显相关性。结论：在基线随机活检患者中，PVI 增加和 PCI 的存在降低了肿瘤负荷增加的风险，并与更具侵袭性的前列腺癌生物学相关。
