Prostate Volume Index and Chronic Inflammation of the Prostate Type IV with Respect to the Risk of Prostate Cancer

Abstract

Background: Benign prostatic hyperplasia and prostate cancer (PCA) alter the normal growth patterns of zonal anatomy with changes of prostate volume (PV). Chronic inflammatory infiltrates (CII) type IV are the most common non-cancer diagnosis of the prostate after biopsy. Objective: To evaluate associations of both PV index (PVI), i.e. the ratio of transitional zone volume (TZV) to peripheral zone volume (PZV), and CII with PCA in patients undergoing biopsy. Subjects and Methods: Between January 2007 and December 2008, 268 consecutive patients who underwent prostate biopsy were retrospectively evaluated. PV and TZV were measured by transrectal ultrasound. PZV was computed by subtracting the PV from the TZV. CII were evaluated according to standard criteria. Significant associations of PVI and the presence of CII (CII+) with PCA risk were assessed by statistical methods. Results and Limitations: We evaluated 251 patients after excluding cases with painful rectal examinations, prostate-specific antigen (PSA) >20 μg/ml and metastases. The PCA detection rate was 41.1%. PVI was a negative independent predictor of PCA. A PVI ≤1.0 was directly [odds ratio (OR) = 2.36] associated with PCA, which was detected more frequently in patients with a PVI ≤1.0 (29.1%) than in those with a PVI >1.0 (11.9%). CII+ was inversely (OR = 0.57) and independently associated with PCA, which was detected less frequently in cases with CII (9.9%) than in those without CII (21.1%). Potential study limitations might relate to the fact that PV was not measured by prostatectomy specimens and there was PSA confounding for CII and PCA. Conclusions: Low values of PVI are directly associated with risk of PCA, which was almost 2.5 times higher in patients with a PVI ≤1.0. The PVI might be an effective parameter for clustering patients at risk of PCA. CII+ was inversely associated with risk of PCA and decreased the probability of detecting PCA by 43%. The role of the PVI and CII in PCA carcinogenesis needs further research.

Prostate Volume Index Associates with a Decreased Risk of Prostate Cancer: Results of a Large Cohort of Patients Elected to a First Biopsy Set

“…As a result, the risk of detecting PCA is increased when PVI ≤ 1 and decreased when PVI >1 according to the pattern of designed anatomical model [9] . CII = Chronic inflammatory infiltrate; GA = glandular atrophia; ASAP = atypical small acinar cell proliferation; HGPIN = high grade prostate intraepithelial neoplasia.…”

“…In patients undergoing biopsy after prostate assessment, we have investigated on associations of PV index (PVI), defined as the ratio of the volume of the transitional zone (TZV) to the volume of the peripheral zone (PZV), with the risk of PCA [9] . It has been shown that PVI associated with a decreased risk of PCA and the odds of detecting PCA was almost two and half times higher in patients with a PVI ≤ 1.0.…”

Low-Risk Prostate Cancer and Tumor Upgrading to Higher Patterns in the Surgical Specimen. Analysis of Clinical Factors Predicting Tumor Upgrading to Higher Gleason Patterns in a Contemporary Series of Patients Who Have Been Evaluated According to the Modified Gleason Score Grading System

“…Second, it was not evaluated whether the PSAD because tumor volume was not significantly associated with upgrading. Indeed, patients with low-grade disease at biopsy tended to have larger prostates [30]. Third, we did not evaluate the role of re-biopsy on tumor upgrading.…”

Inverse Association of Prostatic Chronic Inflammation among Prostate Cancer Tumor Grade Groups: Retrospective Study of 738 Consecutive Cases Elected to a First Random Biopsy Set

“…Total volume of the prostate (TPV) was measured by transrectal ultrasound (TRUS) by using the formula for an ellipsoid, which was transformed into volume (mL). Random 14 cores were taken by TRUS trans-perineum technique [6]. …”

“…Because of the aim of the study, features iii, iv, vi, vii were not considered by the present analysis. In each core, PCI was evaluated according to standard reported criteria [5, 6]. …”