Retrospective Study of the Significant Predictive Role of Inflammatory Degree in Initial and Repeat Prostate Biopsy Specimens for Detecting Prostate Cancer

Abstract

Purpose The purpose of this study was to determine whether histologic inflammation (HI) in initial and repeat prostate biopsy specimens was significantly associated with the detection of prostate cancer. Materials and Methods Between 2005 and 2017, the clinicopathological records of patients with high prostatespecific antigen (PSA) levels who underwent initial and repeat prostate biopsies were retrospectively reviewed. The presence of HI and its degree in each biopsied specimen were interpreted by one uropathologist with 20 years of experience. The association between HI and cancer diagnosis was statistically assessed, with p < 0.05 considered significant, and the cancer and non-cancer groups were compared. Results Among the 522 patients with a median PSA levels of 6.5 ng/dL, including 258 (49.4%) whose cancer was diagnosed following repeat biopsy, the median degrees of HI in the initial and repeat biopsies were 25.0% and 41.7%, respectively. Furthermore, 211 (40.4%) and 247 (47.3%) patients had HI (> 0%) on biopsied specimens, respectively. Comparison of the cancer and noncancer groups revealed that a greater rate of HI specimens in the initial biopsy was associated with fewer prostate cancer diagnoses following repeat biopsy (p < 0.001). Other comparisons between the cancer and non-cancer groups showed that the cancer group had a significantly higher rate of hypertension, whereas those non-cancer group had a significantly higher rate of benign prostatic hyperplasia and prostatitis (p < 0.05). Conclusion A finding of a lesser degree of HI in the initial and a greater degree of HI in the repeat biopsied specimens was associated with the higher probability of cancer diagnosis in patients with high PSA levels.

Evaluation of Knowledge of Medical Students of University of Lom&#233; (Togo) on the Contribution of Prostate Biopsy in the Detection of Prostate Cancer

“…In case of clinical or imaging abnormalities, additional directed biopsies are performed [19]. The indications for a new biopsy are linked to the increase or persistence of a high PSA level, suspect digital rectal examination, and the presence of atypical small acinar proliferation on the first series, the existence of 'a diagnostic doubt on a first series of biopsies [20] The second series must include 4 to 6 additional biopsies, in the anterior apex and the transition zone (anterior fibromuscular stroma) in search of anterior cancer [21]. Many authors have shown in clinical studies that the percentage of cancers detected exclusively by additional transitional zone biopsies is very low [22] [23].…”

Growth and differentiation factor 15 and NF‐κB expression in benign prostatic biopsies and risk of subsequent prostate cancer detection

“…4,5 However, a growing body of evidence from men with benign biopsies followed for subsequent prostate cancer suggests that histologic inflammation may decrease prostate cancer risk. [6][7][8][9] Although several studies have investigated associations between multiple circulating inflammatory markers and prostate cancer risk, [10][11][12] no previous study has, to our knowledge, evaluated the association between pre-diagnostic histologic markers of inflammation in the prostate and subsequent risk of cancer.…”