The influence of chronic inflammation in prostatic carcinogenesis: A 5-year followup study
The influence of chronic inflammation in prostatic carcinogenesis: A 5-year followup study
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DOI：
10.1016/j.juro.2006.04.033
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发表时间：
2006-09-01
影响因子：
6.6
通讯作者：
Gupta, Sanjay
中科院分区：
文献类型：
--
作者：
MacLennan, Gregory T.;Eisenberg, Rosana;Gupta, Sanjay
目的：研究慢性前列腺炎与前列腺癌发生的关系。材料和方法：对177例临床资料可疑为前列腺癌的患者进行前列腺针刺活检。我们评估了他们慢性炎症的存在和程度以及其他病理结果。结果：确定了两个患者亚组，包括144例首次活检中有慢性炎症的患者和33例无慢性炎症的患者。每组中的一些病例的其他病理表现包括单纯性萎缩、高度恶性前列腺上皮内瘤变、腺癌和不典型小腺泡增生。萎缩性后增生和增殖性炎性萎缩仅见于慢性炎症患者。在针吸活检中观察到血清前列腺特异性抗原与炎症程度之间存在显著的相关性。在慢性炎症患者5年内的重复活检中，诊断出29例新的癌症，新的癌症发病率为20%。其中6例发生在最初活检仅显示慢性炎症的患者，15例发生在最初的萎缩后增生/增殖性炎性萎缩病变中，7例发生在最初的高级别前列腺上皮内瘤变和慢性炎症中，1例发生在最初的不典型小腺泡增生和慢性炎症中。初发慢性炎症组有9例新发现高级别前列腺上皮内瘤变，其中7例为萎缩性增生/增生性炎性萎缩，2例为单纯萎缩和慢性炎症。相反，在33例最初没有炎症的患者中，有2例(6%)后来发现了腺癌。其中1例为高级别前列腺上皮内瘤变，1例为非典型小腺泡增生。结论：慢性炎症可能是前列腺癌的重要危险因素。
Purpose: We investigated an association between chronic prostatic inflammation and prostate carcinogenesis.Materials and Methods: Initial prostate needle biopsies from 177 patients with clinical parameters suspicious for malignancy were examined. We evaluated them for the presence and extent of chronic inflammation and other pathological findings. Findings in followup biopsies during the next 5 years were reviewed and correlated with the initial results.Results: Two patients subset were identified, including 144 patients with and 33 without chronic inflammation in the initial biopsies. Additional pathological findings in some cases in each group included simple atrophy, high grade prostatic intraepithelial neoplasia, adenocarcinoma and atypical small acinar proliferation. Post-atrophic hyperplasia and proliferative inflammatory atrophy were noted only in patients with chronic inflammation. A significant association between serum prostate specific antigen and the degree of inflammation was observed in needle biopsies. In repeat biopsies within 5 years in patients with chronic inflammation 29 new cancers were diagnosed, representing a new cancer incidence of 20%. Of these cancers 6 occurred in patients in whom initial biopsies showed only chronic inflammation, 15 occurred in patients with initial post-atrophic hyperplasia/proliferative inflammatory atrophy lesions, 7 occurred in patients with initial high grade prostatic intraepithelial neoplasia and chronic inflammation, and 1 occurred in a patient with initial atypical small acinar proliferation and chronic inflammation. High grade prostatic intraepithelial neoplasia was newly discovered in 9 patients in the initial chronic inflammation group, of whom 7 had post-atrophic hyperplasia/proliferative inflammatory atrophy and 2 had simple atrophy and chronic inflammation in the initial biopsies. In contrast, in 33 patients initially showing no inflammation adenocarcinoma was subsequently found in 2 (6%). One of these patients had high grade prostatic intraepithelial neoplasia and the other had atypical small acinar proliferation on initial biopsies.Conclusions: Chronic inflammation may be a significant risk factor for prostatic adenocarcinoma.