Zhang Lei, Wang Yi, Qin Zhiqiang, Gao Xian, Xing Qianwei, Li Ran, Wang Wei, Song Ninghong, Zhang Wei
Department of Urology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, 210009, China.
Department of Urology, Nanjing First Hospital, Nanjing Medical University, Nanjing, 210006, China.
J Cancer. 2020 Jan 1;11(1):177-189. doi: 10.7150/jca.37235. eCollection 2020.
: No consensus has been reached on the definite associations among prostatitis, benign prostatic hyperplasia (BPH) and prostate cancer (PCa). Hence, this meta-analysis was conducted to explore their triadic relation by summarizing epidemiological evidence. : Systematical and comprehensive retrieval of online databases PubMed, PMC, EMBASE and Web of Science was performed to acquire eligible studies, up to April 1st, 2019. Pooled odds ratios (ORs) with 95% confidence intervals (CIs) were calculated to clarify their correlations. : A total of 42 studies were enrolled in the quality assessment and 35 were finally included in the meta-analyses. Among them, 27 studies were included to describe the association between prostatitis and PCa (OR=1.72, 95% CI=1.44-2.06, =90.1%, <0.001). 21 studies presented significant evidence about the relation between BPH and PCa (OR=2.16, 95% CI=1.75-2.88, =97.1%, <0.001). Due to the huge heterogeneity among studies, those with obvious outliers were excluded based on the Galbraith plots. Ultimately, 17 studies were screened out to assess the association between prostatitis and PCa (OR=1.59, 95% CI=1.48-1.70, =29.4%, =0.123). Meanwhile, 8 studies were retained to evaluate the association between BPH and PCa (OR=3.10, 95% CI=2.87-3.35, =8.4%, =0.365). As for the relation between prostatitis and BPH, a case-control study and a cohort study both supported that prostatitis could enhance the risk of BPH. : Significant correlations were revealed among prostatitis, BPH and PCa. Prostatitis or BPH could lead to escalating risks of PCa. Meanwhile, people with a history of prostatitis might be more vulnerable to BPH.
关于前列腺炎、良性前列腺增生（BPH）和前列腺癌（PCa）之间的确切关联尚未达成共识。因此，本荟萃分析旨在通过总结流行病学证据来探索它们之间的三元关系。通过对在线数据库PubMed、PMC、EMBASE和Web of Science进行系统全面的检索，以获取截至2019年4月1日的符合条件的研究。计算合并优势比（OR）及95%置信区间（CI）以阐明它们之间的相关性。共有42项研究纳入质量评估，最终35项纳入荟萃分析。其中，27项研究用于描述前列腺炎与PCa之间的关联（OR = 1.72，95% CI = 1.44 - 2.06，I² = 90.1%，P < 0.001）。21项研究提供了关于BPH与PCa之间关系的显著证据（OR = 2.16，95% CI = 1.75 - 2.88，I² = 97.1%，P < 0.001）。由于研究之间存在巨大异质性，根据Galbraith图排除了有明显异常值的研究。最终，筛选出17项研究评估前列腺炎与PCa之间的关联（OR = 1.59，95% CI = 1.48 - 1.70，I² = 29.4%，P = 0.123）。同时，保留8项研究评估BPH与PCa之间的关联（OR = 3.10，95% CI = 2.87 - 3.35，I² = 8.4%，P = 0.365）。至于前列腺炎与BPH之间的关系，一项病例对照研究和一项队列研究均支持前列腺炎会增加BPH的风险。前列腺炎、BPH和PCa之间存在显著相关性。前列腺炎或BPH会导致PCa风险升高。同时，有前列腺炎病史的人可能更容易患BPH。
