University of Health Sciences, Bakirkoy Dr. Sadi Konuk Training and Research Hospital, Department of Urology, Istanbul.
Amasya University Medical Faculty, Department of Urology, Amasya.
Arch Ital Urol Androl. 2021 Sep 30;93(3):280-284. doi: 10.4081/aiua.2021.3.280.
This study aimed to determine the predictive effect of the presence of chronic prostatitis associated with prostate cancer (PCa) in prostate biopsy on Gleason score upgrade (GSU) in radical prostatectomy (RP) specimens.
The data of 295 patients who underwent open or robotic RP with a diagnosis of localized PCa following biopsy were retrospectively analyzed. Patients were divided into two groups with and without GSU following RP. Predictive factors affecting GSU on biopsy were determined. The impact of chronic prostatitis associated with prostate cancer on GSU was examined via logistic regression analysis.
Out of 224 patients with Gleason 3+3 scores on biopsy, 145 (64.7%) had Gleason upgrade, and 79 (35.2%) had no upgrade. Whilst comparing the two groups with and without Gleason upgrade in terms of patient age, prostate-specific antigen (PSA) value, PSA density (PSAD), prostate volume (PV), neutrophil/lymphocyte (N/L) ratio, number of positive cores, percentage of positive cores, and Prostate Imaging Reporting and Data System version 2 score, no statistically significant difference was detected. The presence of chronic prostatitis associated with PCa was higher in the patient cohort with GSU in contrast to the other group (p < 0.001). According to the univariate logistic regression analysis, the presence of chronic prostatitis was identified to be an independent marker for GSU.
Pathologists and urologists should be careful regarding the possibility of a more aggressive tumor in the presence of chronic inflammation associated with PCa because inflammation within PCa was revealed to be linked with GSU after RP.
本研究旨在确定前列腺活检中慢性前列腺炎伴前列腺癌（PCa）的存在对根治性前列腺切除术（RP）标本中 Gleason 评分升级（GSU）的预测作用。
回顾性分析了 295 例接受开放或机器人 RP 治疗、活检诊断为局限性 PCa 的患者的数据。患者分为 RP 后 GSU 组和非 GSU 组。确定影响活检中 GSU 的预测因素。通过逻辑回归分析检查慢性前列腺炎与前列腺癌对 GSU 的影响。
在 224 例活检时 Gleason 评分为 3+3 的患者中，145 例（64.7%）发生 Gleason 升级，79 例（35.2%）未升级。在比较两组患者的年龄、前列腺特异性抗原（PSA）值、PSA 密度（PSAD）、前列腺体积（PV）、中性粒细胞/淋巴细胞（N/L）比值、阳性核心数、阳性核心百分比和前列腺影像报告和数据系统 2 评分时，差异无统计学意义。与无 GSU 组相比，GSU 组患者中慢性前列腺炎伴 PCa 的发生率更高（p < 0.001）。单因素逻辑回归分析表明，慢性前列腺炎的存在是 GSU 的独立标志物。
病理学家和泌尿科医生在存在与 PCa 相关的慢性炎症时应注意肿瘤更具侵袭性的可能性，因为在 RP 后发现 PCa 内的炎症与 GSU 有关。
