Inflammation in Prostate Biopsies of Men without Prostatic Malignancy or Clinical Prostatitis

Schatteman, P.H.F.; Hoekx, Lucien; Wyndaele, Jean Jacques; Jeuris, W.; Marck, E. Van

doi:10.1159/000020161

Cited by 144 publications

(104 citation statements)

References 23 publications

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“…5 The association of serum PSA with histological inflammation has also been reported. 3 Thus, histological inflammation in the initial biopsy specimens can be useful to predict the result of repeat biopsy, but this strategy cannot be used to predict the initial biopsy findings. Models for predicting the result of initial biopsy have used many parameters, such as abnormal digital rectal examination, age, PSA, percent-free PSA, prostate volume, and prostate cancer antigen 3.…”

Section: Discussionmentioning

confidence: 99%

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Low serum neutrophil count predicts a positive prostate biopsy

Fujita

Imamura

Tanigawa

et al. 2012

Prostate Cancer Prostatic Dis

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BACKGROUND: Asymptomatic prostatic inflammation may cause increased PSA in some men, leading to unnecessary prostate biopsy. We investigated whether the differential white cell count could predict the result of prostate biopsy. METHODS: Prostate needle biopsy was carried out in 323 Japanese men with elevated PSA levels or abnormal digital rectal findings. White blood cell count (WBC), differential white cell count (neutrophils, lymphocytes, basophils, eosinophils, and monocytes), and serum C-reactive protein level were assessed for associations with biopsy findings. RESULTS: In all, 203 (62.1%) were positive for prostate cancer. WBC, neutrophil count, age, PSA, prostate volume, and PSA density (PSAD) were associated with the results of biopsy (Po0.05). Multivariate analysis showed that neutrophil count, age, PSA, prostate volume and PSAD were independent predictors. When the cut-off neutrophil count was set at 2900 ml À1, 78 of 104 men (75.0%) with a count below this value had a positive biopsy, while 125 of 219 (57.0%) men with a count above this value were positive. The area under the receiver-operator characteristics curve (AUC) for the predicted probability of a positive biopsy for prostate cancer according to the optimum logistic model was 0.83 (95% confidence interval (CI) 0.78--0.87), while the AUC for PSA was 0.70 (95% CI 0.64--0.76) and that for PSAD was 0.79 (95% CI 0.74--0.84). CONCLUSIONS: An elevated neutrophil count may be a good indicator of a benign prostate biopsy. Men with a low neutrophil count and an increase of serum PSA should strongly be considered for biopsy.

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Section: Discussionmentioning

confidence: 99%

“…3,4 Acute and chronic inflammation in biopsy specimens is a significant predictor of the serum PSA level. Histological inflammation in needle biopsy specimens and infiltration of polymorphonuclear leukocytes are correlated with an increase of serum PSA and with the results of repeat biopsy.…”

Section: 2mentioning

confidence: 99%

Low serum neutrophil count predicts a positive prostate biopsy

Fujita

Imamura

Tanigawa

et al. 2012

Prostate Cancer Prostatic Dis

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“…Uroflowmetry data included voided volume, maximum flow rate, average flow rate, and post-void residual urine (PVR) volume. IPSS was evaluated using a total index score (items 1-7), storage subscale (items 2,4,7), voiding subscale (items 1,3,5,6), and a quality of life item. Total and transitional zone prostate volumes and serum PSA levels were analyzed according to the prostatic inflammation grade.…”

Section: Evaluationsmentioning

confidence: 99%

“…The presence of chronic histologic inflammation is a common finding in prostatic tissue on biopsies of surgical specimens from patients with and without lower urinary tract symptoms (LUTS) or prostatitis (1)(2)(3). Although it is not yet defined when and why chronic inflammation occurs, it has been hypothesized that BPH is an immune-mediated inflammatory disease (2,4,5).…”

Section: Introductionmentioning

confidence: 99%

Effects of prostatic inflammation on LUTS and alpha blocker treatment outcomes

et al. 2014

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ARTICLE INFO ______________________________________________________________ ______________________Purpose: To evaluate the association between prostatic inflammation and lower urinary tract symptoms (LUTS), and to identify the effects of prostatic inflammation on the treatment with an alpha blocker. Materials and Methods:111 Participants who were aged ≥ 50 years, the presence of LUTS (maximal flow rate < 20 m/s, IPSS ≥ 11), and an elevated PSA level (3-20ng/mL) were treated with tamsulosin 0.2mg once daily for 3 months after prostate biopsies. Prostatic inflammation was scored as none (0), mild (I), moderate (II), or marked (III). LUTS parameters including urine flow rates, IPSS, PSA, and prostate volume were evaluated.Results: Inflammation grading resulted in 25, 60, and 26 patients that were grade 0, I, and II, respectively. Lower grade inflammation was related to higher urine flow rate at baseline. Patients with higher inflammation grades had larger prostate volumes, larger total and transitional zone volumes, and higher PSA levels. Overall, urine flow rates and residual urine volume were improved after 3 months of alpha blocker therapy. Eighty percent of patients with grade 0 inflammation, 73% of patients with grade I inflammation, and 92.3% of patients with grade II inflammation showed improvement of LUTS after treatment. Longer duration of treatment was related to a decreased chance of improvement of LUTS. Patients with increased IPSS voiding subscales could be predictive of improvement of LUTS. Conclusions: Patients with high grade inflammation had lower flow rates and higher prostatic volumes than patients with low grade inflammation. Inflammation grade did not affect the outcomes of alpha blocker treatment.

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“…For prostate cancer specifically, there is evidence that chronic or recurrent inflammation plays an important role in prostate cancer initiation, development, progression, and metastasis [3]. Biopsies in several carcinogenic and non-carcinogenic prostate diseases show signs of inflammation, including prostatitis, benign prostatic hyperplasia (BPH), prostate cancer "risk lesions" (proliferative inflammatory atrophy (PIA), prostatic intraepithelial neoplasia (PIN)), and prostate cancer [4][5][6].…”

Section: Introductionmentioning

confidence: 99%

Maintenance use of aspirin or other non-steroidal anti-inflammatory drugs (NSAIDs) and prostate cancer risk

Brusselaers

2017

Prostate Cancer Prostatic Dis

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Background Aspirin and other non-steroidal anti-inflammatory drugs (NSAIDs) may have a preventive effect against prostate cancer. However, evidence is limited and still controversial, especially considering non-aspirin non-steroidal antiinflammatory drugs (NSAIDs). Methods Swedish nationwide population-based cohort study including all long-term (≥180 days) adult male users of aspirin (n = 419,931) or NSAIDs (n = 223,437) followed from the first dispense date until the first cancer diagnosis, death or 31 December 2012, whichever occurred first. The risk of prostate cancer was measured as standardized incidence ratios (SIR) and 95% confidence intervals (CI), assessing duration of use, age and concomitant statins intake, comparing to the general male background population of the same age in Sweden.Results The overall SIR suggests that maintenance use of aspirin decreases the risk of prostate cancer (SIR = 0.87, 95% CI 0.85-0.88), in particular if used ≥5 years (SIR = 0.31, 95% CI 0.30-0.32). The overall risk was decreased (SIR = 0.87, 95% CI 0.85-0.90) among other NSAIDs users, and again in particular among longer-term users (≥3 years) with SIR = 0.58 (95% CI 0.53-0.63). When statins users were excluded from all aspirin users, there was no remaining association with prostate cancer (SIR = 0.99, 95% CI 0.96-1.02), only if taken ≥5 years (SIR = 0.31, 95% CI 0.29-0.34). For non-aspirin NSAIDs users, the protective effect remained after exclusion of statins users (SIR = 0.92, 95% CI 0.88-0.95). Conclusions This population-based cohort study provides evidence for a protective effect of aspirin and other NSAIDs against prostate cancer, in particular for longer durations of use, yet concomitant use of statins strongly influences the risk among aspirin users.

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Inflammation in Prostate Biopsies of Men without Prostatic Malignancy or Clinical Prostatitis

Cited by 144 publications

References 23 publications

Low serum neutrophil count predicts a positive prostate biopsy

Low serum neutrophil count predicts a positive prostate biopsy

Effects of prostatic inflammation on LUTS and alpha blocker treatment outcomes

Maintenance use of aspirin or other non-steroidal anti-inflammatory drugs (NSAIDs) and prostate cancer risk

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