Corpora amylacea in benign prostatic acini are associated with concurrent, predominantly low‐grade cancer

Abstract

Background: Corpora amylacea (CAM), in benign prostatic acini, contain acutephase proteins. Do CAM coincide with carcinoma?Methods: Within 270 biopsies, 83 prostatectomies, and 33 transurethral resections (TURs), CAM absence was designated CAM 0; corpora in less than 5% of benign acini: CAM 1; in 5% to 25%: CAM 2; in more than 25%: CAM 3. CAM were compared against carcinoma presence, clinicopathologic findings, and grade groups (GG) 1 to 2 vs 3 to 5.The frequency of CAM according to anatomic zone was counted. A pilot study was conducted using paired initial benign and repeat biopsies (33 benign, 24 carcinoma).Results: A total of 68.9% of biopsies, 96.4% of prostatectomies, and 66.7% of TURs disclosed CAM. CAM ≥1 was common at an older age (P = .019). In biopsies, 204 cases (75%) had carcinoma; and CAM of 2 to 3 (compared to 0-1) were recorded in 25.0% of carcinomas but only 7.4% of benign biopsies (P = .005; odds ratio [OR] = 5.1). CAM correlated with high percent Gleason pattern 3, low GG (P = .035), and chronic inflammation (CI). CI correlated inversely with carcinoma (P = .003). CAM disclosed no association with race, body mass index, serum prostate specific antigen (PSA), acute inflammation (in biopsies), atrophy, or carcinoma volume.With CAM 1, the odds of GG 3 to 5 carcinoma, by comparison to CAM 0, decreased more than 2× (OR = 0.48; P = .032), with CAM 2, more than 3× (OR = 0.33; P = .005), and with CAM 3, almost 3× (OR = 0.39, P = .086). For men aged less than 65, carcinoma predictive model was: Score = (2 × age) + (5 × PSA) − (20 × degree of CAM); using our data, area under the ROC curve was 78.17%. When the transition zone was involved by cancer, it showed more CAM than in cases where it was uninvolved (P = .012); otherwise zonal distributions were similar.In the pilot study, CAM ≥1 predicted carcinoma on repeat biopsy (P < .05; OR = 8), as did CAM 2 to 3 (P < .0001; OR = 30). CI was not significant, and CAM retained significance after adjusting for CI. Conclusion: CAM correlate with carcinoma. Whether abundant CAM in benign biopsies adds value amidst high clinical suspicion, warrants further study. K E Y W O R D S corpora amylacea, inflammation, peripheral zone, prediction of cancer, prostate cancer, transition zone 688 | PALANGMONTHIP ET AL.

Amyloid-Forming Corpora Amylacea and Spheroid-Type Amyloid Deposition: Comprehensive Analysis Using Immunohistochemistry, Proteomics, and a Literature Review

“…We observed pCR-positive deposits not only in benign acini but also in cancer acini. Although CAs are primarily noted in benign acini, they have been identified in 0.4%-13% of cancer acini [49]. Therefore, the observation of amyloid-forming deposits in the lumen of cancer acini is not surprising; however, it is noteworthy that neither the tumor glands nor their luminal deposits were immunoreactive to lactoferrin.…”

“…This suggests a common mechanism underlying the formation of CAs in the lungs and prostate. CAs are frequently identified in normal prostate tissue [49], and their presence does not appear to damage the surrounding tissues in the prostate and lung. Thus, we can speculate that CAs in these organs are formed for physiological reasons rather than serving a pathological function.…”

Melatonin ameliorates degenerative alterations caused by age in the rat prostate and mitigates high‐fat diet damages

“…In the human prostate, CA occurrence with aging (Klimas et al, 1985; Sfanos et al, 2009; Shakya et al, 2003) has been reported, but its origin is not fully elucidated. Studies reported associations of epithelium damage, chronic and acute inflammation, and urinary retention (Cross et al, 1992; Klimas et al, 1985; Palangmonthip et al, 2020; Sfanos et al, 2009). The presence of glycoconjugates suggests its formation partially by prostatic secretion (Morales et al, 2005) which is in line with our findings.…”

“…Thus, it is reasonable to suggest that CA formation may also be related to changes in metabolism, which is altered during prostate carcinogenesis. In addition, CA deposition was described in 55% of high‐grade PIN cases (Bostwick et al, 1993) as well as hyperplasia and prostate carcinoma (Christian et al, 2005; Palangmonthip et al, 2020). Thus, the decrease of CA incidence may be due to the MLT protective role against oxidative damage, including the increase of GST activity, which avoided tissue dysfunction over time.…”

The Etiology and Pathophysiology Genesis of Benign Prostatic Hyperplasia and Prostate Cancer: A New Perspective

“…Corpora amylacea (starch-like bodies) and calculi are luminal bodies commonly present in benign prostatic acini [117,118] and in prostate [117][118][119][120][121][122][123][124]; they are also found in approximately 25% of men aged between 20 and 40 years [122]. Amyloid formation by the pro-inflammatory S100A8/A9 proteins has been detected in the ageing prostate [125][126][127][128][129].…”