Examination of the relationship between symptoms of prostatitis and histological inflammation: Baseline data from the REDUCE chemoprevention trial
Examination of the relationship between symptoms of prostatitis and histological inflammation: Baseline data from the REDUCE chemoprevention trial
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DOI：
10.1016/j.juro.2007.05.041
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发表时间：
2007-09-01
影响因子：
6.6
通讯作者：
Rittmaster, Roger S.
中科院分区：
文献类型：
--
作者：
Nickel, J. Curtis;Roehrborn, Claus G.;Rittmaster, Roger S.
目的：非细菌性慢性前列腺炎/慢性盆腔疼痛综合征的症状被认为与前列腺炎有关。Dutasteride正在进行的前列腺癌事件减少试验是一项为期4年的第三阶段安慰剂对照研究，目的是确定每天0.5毫克的Dutasteride是否降低活组织检查可检测到的前列腺癌的风险。材料和方法：符合条件的男性包括：血清前列腺特异性抗原2.5 ng/ml或以上，10 ng/ml以下(50~60岁)，或3.0 ng/ml以上10 ng/ml以下(60岁以上)，国际前列腺症状评分小于25分(如果已经接受α-受体阻滞剂治疗)。急性前列腺炎是一个排除标准。美国国立卫生研究院慢性前列腺炎症状指数被用来评估前列腺炎样症状。采用Spearman等级相关分析评估急性炎症与慢性炎症的关系，慢性前列腺炎症状指数在疼痛、泌尿症状和生活质量领域的评分，以及平均疼痛、总分和前列腺炎样症状。结果：5597例患者获得数据。有和没有慢性前列腺炎样症状的患者的炎症状态分布相似。平均慢性炎症与慢性前列腺炎症状指数总分、尿路症状和生活质量分值之间存在显著相关性，但相关程度较小。结论：前列腺炎样疼痛症状与组织学炎症之间缺乏有临床意义的相关性，提示慢性前列腺炎/慢性盆腔疼痛综合征症状与前列腺癌炎症相关的观点值得进一步研究。
Purpose: Symptoms of abacterial chronic prostatitis/chronic pelvic pain syndrome are considered to be associated with prostate inflammation. The ongoing Reduction by Dutasteride of Prostate Cancer Events trial is a 4-year, phase III, placebo controlled study to determine whether 0.5 mg dutasteride daily decreases the risk of biopsy detectable prostate cancer. All men underwent biopsy before study entry, allowing review of the relationship between histological prostate inflammation and prostatitis symptoms.Materials and Methods: Eligible men were 50 to 75 years old with serum prostate specific antigen 2.5 ng/ml or greater and 10 ng/ml or less (ages 50 to 60 years), or 3.0 ng/ml or greater and 10 ng/ml or less (older than 60 years), and an International Prostate Symptom Score of less than 25 (or less than 20 if already on a-blocker therapy). Acute prostatitis was an exclusion criterion. The National Institutes of Health Chronic Prostatitis Symptom Index was used to assess prostatitis-like symptoms. Spearman rank correlations were used to assess the relationship between acute and chronic inflammation, and Chronic Prostatitis Symptom Index scores for the pain, urinary symptoms and quality of life domains as well as average pain, total score and prostatitis-like symptoms.Results: Data were available on 5,597 patients. The distribution of inflammation status was similar for those with and without chronic prostatitis-like symptoms. Significant correlations were found between average chronic inflammation, and total Chronic Prostatitis Symptom Index score and subscores for urinary symptoms and quality of life but the magnitude of these correlations was small.Conclusions: A lack of clinically meaningful association was found between prostatitis-like pain symptoms and histological inflammation in the Reduction by Dutasteride of Prostate Cancer Events population, suggesting that the view that symptoms of chronic prostatitis/chronic pelvic pain syndrome and prostate inflammation are associated needs further scrutiny.