Departments of Pathology and Laboratory Medicine, University of Miami Miller School of Medicine, Miami, FL.
Desai Sethi Urology Institute, University of Miami Miller School of Medicine, Miami, FL.
Urology. 2022 Jun;164:46-49. doi: 10.1016/j.urology.2021.12.008. Epub 2021 Dec 26.
To investigate if localized amyloidosis of the seminal tract (LAST) is associated with subsequent development of systemic amyloidosis. Prior reports recorded no systemic amyloidosis at the time of LAST diagnosis. However, no follow-up studies exist to confirm that LAST is not a risk factor for subsequent development of systemic amyloidosis.
Our study cohort included patients whose prostate biopsy (PB) or radical prostatectomy (RP) specimen demonstrated LAST between 2014-2021. Clinical variables including age, race/ethnicity, prostate specific antigen (PSA), and prostate weight were analyzed. Patients were assessed for clinical and laboratory evidence of systemic amyloidosis and lymphoproliferative conditions during the follow-up period.
Thirty-six men (26 RPs, 9 PBs, and 1 cystoprostatectomy) had LAST. Our study cohort included 18 white Hispanic, 9 white non-Hispanic, 7 black, and 1 Asian men. Median age was 67 years, mean PSA was 9.8 ng/mL. Over a median follow-up period of 20 months (mean, 30) in 27 men, none developed systemic amyloidosis. Frequency of LAST in RP specimens was 1.2% (26/2,135) and corelated with age (67 vs 63 years, P-value = .004). Race/ethnicity, PSA, and prostate weight were not associated with the incidence of LAST.
LAST is not a harbinger of systemic disease. The incidence of LAST in a contemporary RP cohort is significantly lower than in previously published studies. While patient age positively corelates with LAST, PSA and prostate weight are not associated with the condition. There is no difference in the frequency of LAST between white Hispanic, white non-Hispanic, and black men.
研究精囊局部淀粉样变（LAST）是否与随后发生的系统性淀粉样变性有关。先前的报告记录在 LAST 诊断时没有系统性淀粉样变性。然而，目前还没有随访研究证实 LAST 不是随后发生系统性淀粉样变性的危险因素。
我们的研究队列包括 2014 年至 2021 年间前列腺活检（PB）或根治性前列腺切除术（RP）标本显示 LAST 的患者。分析了年龄、种族/民族、前列腺特异性抗原（PSA）和前列腺重量等临床变量。在随访期间，评估患者是否有系统性淀粉样变性和淋巴增生性疾病的临床和实验室证据。
36 名男性（26 例 RP、9 例 PB 和 1 例膀胱前列腺切除术）有 LAST。我们的研究队列包括 18 名白西班牙裔、9 名白非西班牙裔、7 名黑人和 1 名亚裔男性。中位年龄为 67 岁，平均 PSA 为 9.8ng/ml。在 27 名男性中位随访时间为 20 个月（平均 30 个月）期间，没有人发生系统性淀粉样变性。RP 标本中 LAST 的频率为 1.2%（26/2135），与年龄相关（67 岁比 63 岁，P 值=0.004）。种族/民族、PSA 和前列腺重量与 LAST 的发生率无关。
LAST 不是系统性疾病的先兆。在当代 RP 队列中，LAST 的发生率明显低于先前的研究。虽然患者年龄与 LAST 呈正相关，但 PSA 和前列腺重量与 LAST 无关。白西班牙裔、白非西班牙裔和黑人间 LAST 的频率无差异。
