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Duan J, Liu Z, Li Z, Wang H, Zhao W. Research on the mean maximum Young's modulus value as a new diagnostic parameter for prostate cancer. Sci Rep 2024; 14:16828. [PMID: 39039192 PMCID: PMC11263570 DOI: 10.1038/s41598-024-68036-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2024] [Accepted: 07/18/2024] [Indexed: 07/24/2024] Open
Abstract
Ultrasound-based shear wave elastography (SWE) can non-invasively assess prostate tissue stiffness for the diagnosis of prostate cancer (PCa). So far, there is no widely recognized standard for the detection process and calculation method of Young's modulus value in transrectal SWE ultrasound imaging (TSWEUI). In our study, the mean maximum Young's modulus value (m-Emax) of the maximum cross-section of prostate is obtained by calculating the mean of 12 measured Emax in the four quadrants. This retrospective study included 209 suspected malignant prostate disease patients with pathological results in our hospital. Among the 209 patients, 75 patients completed TSWEUI, and 63 of the 75 patients completed magnetic resonance imaging (MRI). The area under the receiver operating characteristic (ROC) curve (AUC) of 75 patients for m-Emax was 0.754. The prostate volume, prostate-specific antigen, and m-Emax were used to develop a nomogram (AUC = 0.868). The nomogram could effectively predict the probability of PCa, thereby reducing the needle biopsy rate for diagnosing PCa. The AUC of 63 patients was not statistically different between m-Emax (AUC = 0.717) and MRI (AUC = 0.787) (P = 0.361). These indicate that m-Emax can be used as an innovative parameter in TSWEUI to diagnosis PCa. TSWEUI is more cost-effective than MRI in diagnosing PCa.
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Affiliation(s)
- Jieyu Duan
- Department of Ultrasound, First Affiliated Hospital of Zhengzhou University, Zhengzhoug City, 450052, Henan Province, China
| | - ZhanHui Liu
- Department of Radiology, The First Hospital of Hebei Medical University, Shijiazhuang City, 050031, Hebei Province, China
| | - Zhong Li
- Department of Urology, The First Hospital of Hebei Medical University, Shijiazhuang City, 050031, Hebei Province, China
| | - Haoyu Wang
- Department of Ultrasound, The First Hospital of Hebei Medical University, 89 Donggang Road, Yuhua District, Shijiazhuang City, 050031, Hebei Province, China
| | - Wei Zhao
- Department of Ultrasound, The First Hospital of Hebei Medical University, 89 Donggang Road, Yuhua District, Shijiazhuang City, 050031, Hebei Province, China.
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Pérez-Gómez JM, Montero-Hidalgo AJ, Fuentes-Fayos AC, Sarmento-Cabral A, Guzmán-Ruiz R, Malagón MM, Herrera-Martínez AD, Gahete MD, Luque RM. Exploring the role of the inflammasomes on prostate cancer: Interplay with obesity. Rev Endocr Metab Disord 2023; 24:1165-1187. [PMID: 37819510 PMCID: PMC10697898 DOI: 10.1007/s11154-023-09838-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 09/21/2023] [Indexed: 10/13/2023]
Abstract
Obesity is a weight-related disorder characterized by excessive adipose tissue growth and dysfunction which leads to the onset of a systemic chronic low-grade inflammatory state. Likewise, inflammation is considered a classic cancer hallmark affecting several steps of carcinogenesis and tumor progression. In this regard, novel molecular complexes termed inflammasomes have been identified which are able to react to a wide spectrum of insults, impacting several metabolic-related disorders, but their contribution to cancer biology remains unclear. In this context, prostate cancer (PCa) has a markedly inflammatory component, and patients frequently are elderly individuals who exhibit weight-related disorders, being obesity the most prevalent condition. Therefore, inflammation, and specifically, inflammasome complexes, could be crucial players in the interplay between PCa and metabolic disorders. In this review, we will: 1) discuss the potential role of each inflammasome component (sensor, molecular adaptor, and targets) in PCa pathophysiology, placing special emphasis on IL-1β/NF-kB pathway and ROS and hypoxia influence; 2) explore the association between inflammasomes and obesity, and how these molecular complexes could act as the cornerstone between the obesity and PCa; and, 3) compile current clinical trials regarding inflammasome targeting, providing some insights about their potential use in the clinical practice.
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Affiliation(s)
- Jesús M Pérez-Gómez
- Maimonides Biomedical Research Institute of Cordoba (IMIBIC), IMIBIC Building, Av. Menéndez Pidal s/n, 14004, Córdoba, Spain
- Department of Cell Biology, Physiology, and Immunology, University of Córdoba, Cordoba, Spain
- Hospital Universitario Reina Sofía (HURS), Cordoba, Spain
- Centro de Investigación Biomédica en Red de Fisiopatología de la Obesidad y Nutrición, (CIBERobn), Cordoba, Spain
| | - Antonio J Montero-Hidalgo
- Maimonides Biomedical Research Institute of Cordoba (IMIBIC), IMIBIC Building, Av. Menéndez Pidal s/n, 14004, Córdoba, Spain
- Department of Cell Biology, Physiology, and Immunology, University of Córdoba, Cordoba, Spain
- Hospital Universitario Reina Sofía (HURS), Cordoba, Spain
- Centro de Investigación Biomédica en Red de Fisiopatología de la Obesidad y Nutrición, (CIBERobn), Cordoba, Spain
| | - Antonio C Fuentes-Fayos
- Maimonides Biomedical Research Institute of Cordoba (IMIBIC), IMIBIC Building, Av. Menéndez Pidal s/n, 14004, Córdoba, Spain
- Department of Cell Biology, Physiology, and Immunology, University of Córdoba, Cordoba, Spain
- Hospital Universitario Reina Sofía (HURS), Cordoba, Spain
- Centro de Investigación Biomédica en Red de Fisiopatología de la Obesidad y Nutrición, (CIBERobn), Cordoba, Spain
| | - André Sarmento-Cabral
- Maimonides Biomedical Research Institute of Cordoba (IMIBIC), IMIBIC Building, Av. Menéndez Pidal s/n, 14004, Córdoba, Spain
- Department of Cell Biology, Physiology, and Immunology, University of Córdoba, Cordoba, Spain
- Hospital Universitario Reina Sofía (HURS), Cordoba, Spain
- Centro de Investigación Biomédica en Red de Fisiopatología de la Obesidad y Nutrición, (CIBERobn), Cordoba, Spain
| | - Rocio Guzmán-Ruiz
- Maimonides Biomedical Research Institute of Cordoba (IMIBIC), IMIBIC Building, Av. Menéndez Pidal s/n, 14004, Córdoba, Spain
- Department of Cell Biology, Physiology, and Immunology, University of Córdoba, Cordoba, Spain
- Hospital Universitario Reina Sofía (HURS), Cordoba, Spain
- Centro de Investigación Biomédica en Red de Fisiopatología de la Obesidad y Nutrición, (CIBERobn), Cordoba, Spain
| | - María M Malagón
- Maimonides Biomedical Research Institute of Cordoba (IMIBIC), IMIBIC Building, Av. Menéndez Pidal s/n, 14004, Córdoba, Spain
- Department of Cell Biology, Physiology, and Immunology, University of Córdoba, Cordoba, Spain
- Hospital Universitario Reina Sofía (HURS), Cordoba, Spain
- Centro de Investigación Biomédica en Red de Fisiopatología de la Obesidad y Nutrición, (CIBERobn), Cordoba, Spain
| | - Aura D Herrera-Martínez
- Maimonides Biomedical Research Institute of Cordoba (IMIBIC), IMIBIC Building, Av. Menéndez Pidal s/n, 14004, Córdoba, Spain
- Hospital Universitario Reina Sofía (HURS), Cordoba, Spain
- Endocrinology and Nutrition Service, HURS/IMIBIC, Córdoba, Spain
| | - Manuel D Gahete
- Maimonides Biomedical Research Institute of Cordoba (IMIBIC), IMIBIC Building, Av. Menéndez Pidal s/n, 14004, Córdoba, Spain
- Department of Cell Biology, Physiology, and Immunology, University of Córdoba, Cordoba, Spain
- Hospital Universitario Reina Sofía (HURS), Cordoba, Spain
- Centro de Investigación Biomédica en Red de Fisiopatología de la Obesidad y Nutrición, (CIBERobn), Cordoba, Spain
| | - Raúl M Luque
- Maimonides Biomedical Research Institute of Cordoba (IMIBIC), IMIBIC Building, Av. Menéndez Pidal s/n, 14004, Córdoba, Spain.
- Department of Cell Biology, Physiology, and Immunology, University of Córdoba, Cordoba, Spain.
- Hospital Universitario Reina Sofía (HURS), Cordoba, Spain.
- Centro de Investigación Biomédica en Red de Fisiopatología de la Obesidad y Nutrición, (CIBERobn), Cordoba, Spain.
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3
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Jung G, Kim JK, Kim H, Lee J, Hong SK. The association between prostatitis and risk of prostate cancer: a National Health Insurance Database study. World J Urol 2022; 40:2781-2787. [PMID: 36201020 DOI: 10.1007/s00345-022-04165-2] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2022] [Accepted: 09/24/2022] [Indexed: 10/10/2022] Open
Abstract
PURPOSE Inflammation is thought to affect the development of prostate cancer (PCa). By retrospectively investigating the database of the National Health Insurance Service, this study attempted to perform a relevant analysis of patients with prostatitis and PCa. METHODS Participants were aged ≥ 50 years. Patients diagnosed with prostatitis between 2010 and 2013 and matched controls were followed up until 2019. We selected controls with matched propensity scores for age, diabetes, hypertension, and the Charlson comorbidity index. Multivariate Cox regression analysis was conducted to determine the hazard ratio (HR) and 95% confidence interval (CI) of the association between prostatitis and PCa. The HR for PCa according to the presence of prostatitis was classified as acute, chronic, or other prostatitis. RESULTS A total of 746,176 patients from each group were analyzed. The incidence of PCa was significantly higher in the group with prostatitis (1.8% vs 0.6%, p < 0.001). The HR for PCa was significantly higher in patients with prostatitis (HR 2.99; 95% CI 2.89-3.09, p < 0.001). The HR for PCa was significantly higher in acute prostatitis than in chronic prostatitis (3.82; 95% CI 3.58-4.08; p < 0.001; HR 2.77; 95% CI 2.67-2.87, p < 0.001). The incidence of all-cause death in patients diagnosed PCa was significantly lower in prostatitis group (HR 0.58, 95% CI 0.53-0.63, p < 0.001). CONCLUSION Prostatitis is associated with an increased incidence of PCa. Acute prostatitis is associated with higher risk of PCa than chronic prostatitis. Clinicians should inform patients with prostatitis that they may have an increased risk of diagnosing PCa, and follow-up is needed.
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Affiliation(s)
- Gyoohwan Jung
- Department of Urology, Seoul National University Bundang Hospital, 173-82, Gumi-Ro, Bundang-gu, Seongnam-si, Gyeonggi-do, 13620, South Korea
| | - Jung Kwon Kim
- Department of Urology, Seoul National University Bundang Hospital, 173-82, Gumi-Ro, Bundang-gu, Seongnam-si, Gyeonggi-do, 13620, South Korea
| | - Hasung Kim
- Data Science Team, Hanmi Pharm. Co., Ltd, Seoul, South Korea
| | - Jungkuk Lee
- Data Science Team, Hanmi Pharm. Co., Ltd, Seoul, South Korea
| | - Sung Kyu Hong
- Department of Urology, Seoul National University Bundang Hospital, 173-82, Gumi-Ro, Bundang-gu, Seongnam-si, Gyeonggi-do, 13620, South Korea. .,Department of Urology, Seoul National University College of Medicine, Seoul, South Korea.
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4
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Li L, Gu L, Kang B, Yang J, Wu Y, Liu H, Lai S, Wu X, Jiang J. Evaluation of the Efficiency of MRI-Based Radiomics Classifiers in the Diagnosis of Prostate Lesions. Front Oncol 2022; 12:934108. [PMID: 35865467 PMCID: PMC9295912 DOI: 10.3389/fonc.2022.934108] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2022] [Accepted: 06/07/2022] [Indexed: 12/24/2022] Open
Abstract
ObjectiveTo compare the performance of different imaging classifiers in the prospective diagnosis of prostate diseases based on multiparameter MRI.MethodsA total of 238 patients with pathological outcomes were enrolled from September 2019 to July 2021, including 142 in the training set and 96 in the test set. After the regions of interest were manually segmented, decision tree (DT), Gaussian naive Bayes (GNB), XGBoost, logistic regression, random forest (RF) and support vector machine classifier (SVC) models were established on the training set and tested on the independent test set. The prospective diagnostic performance of each classifier was compared by using the AUC, F1-score and Brier score.ResultsIn the patient-based data set, the top three classifiers of combined sequences in terms of the AUC were logistic regression (0.865), RF (0.862), and DT (0.852); RF “was significantly different from the other two classifiers (P =0.022, P =0.005), while logistic regression and DT had no statistical significance (P =0.802). In the lesions-based data set, the top three classifiers of combined sequences in terms of the AUC were RF (0.931), logistic regression (0.922) and GNB (0.922). These three classifiers were significantly different from.ConclusionThe results of this experiment show that radiomics has a high diagnostic efficiency for prostate lesions. The RF classifier generally performed better overall than the other classifiers in the experiment. The XGBoost and logistic regression models also had high classification value in the lesions-based data set.
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Affiliation(s)
- Linghao Li
- Department of Radiology, the First Affiliated Hospital, Nanchang University, Nanchang, China
| | - Lili Gu
- Department of Pain, the First Affiliated Hospital, Nanchang University, Nanchang, China
| | - Bin Kang
- Department of Radiology, the First Affiliated Hospital, Nanchang University, Nanchang, China
| | - Jiaojiao Yang
- Department of Radiology, the First Affiliated Hospital, Nanchang University, Nanchang, China
| | - Ying Wu
- Department of Radiology, the First Affiliated Hospital, Nanchang University, Nanchang, China
| | - Hao Liu
- Department of Radiology, the First Affiliated Hospital, Nanchang University, Nanchang, China
| | - Shasha Lai
- Department of Radiology, the First Affiliated Hospital, Nanchang University, Nanchang, China
| | - Xueting Wu
- Department of Radiology, the First Affiliated Hospital, Nanchang University, Nanchang, China
| | - Jian Jiang
- Department of Radiology, the First Affiliated Hospital, Nanchang University, Nanchang, China
- *Correspondence: Jian Jiang,
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Fibromodulin Gene Variants (FMOD) as Potential Biomarkers for Prostate Cancer and Benign Prostatic Hyperplasia. DISEASE MARKERS 2022; 2022:5215247. [PMID: 35686032 PMCID: PMC9173908 DOI: 10.1155/2022/5215247] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/21/2022] [Accepted: 04/27/2022] [Indexed: 11/18/2022]
Abstract
By the year 2050, the world's elderly population may increase exponentially, raising the rate of disease characteristic of this group, such as prostate cancer (PCa) and benign prostatic hyperplasia (BPH). Prostate disorders have a multifactorial etiology, especially age and genetic factors. Currently, PCa is the second most frequent neoplasm in the male population worldwide. The fibromodulin gene encodes a small leucine-rich proteoglycan (SLRP) which acts in the collagen fibrillogenesis pathway, cell adhesion, and modulation of TGF-β signaling pathways, which has been recently associated with PCa. The present study sequenced the coding region of the FMOD in a sample of 44 PCa, 90 BPH, and 82 controls from a Brazilian population, and the results identified 6 variants: 2 missenses (p.(Tyr42Ser) and p.(Pro24Ala)); 3 synonymous (p.(His253=), p.(Asn353=), and p.(Glu79=)); and 1 intronic (c.980-114A>G). Of these, p.(Tyr42Ser), p.(Pro24Ala), and p.(Asn353=) are rare variants, and p.(Tyr42Ser) was predicted as potential pathogenic by the algorithms used here, in addition to not being observed in controls, suggesting that may be a potential biomarker for development of PCa and BPH. In conclusion, we identified for the first time, in Brazilian individuals with PCa and BPH, a potentially pathogenic variant in the analysis of FMOD gene. Further studies are needed to investigate the deleterious effect of this variant on the structure and/or function of the FMOD protein.
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6
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Lin L, Xia S, Zhang W, Chen S. Influence of Trichomonas vaginalis macrophage migration inhibitory factor on the proliferation activity of prostate epithelial cell line and its preliminary mechanism. Andrologia 2022; 54:e14397. [PMID: 35191055 DOI: 10.1111/and.14397] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2021] [Revised: 01/24/2022] [Accepted: 02/09/2022] [Indexed: 11/29/2022] Open
Abstract
Currently, the pathogenesis of prostate diseases is still under investigation, but it is generally clinically recognized to be related to the imbalance of prostate cell viability. Trichomonas vaginalis macrophage migration inhibitory factor (TvMIF) has been reported to induce the proliferation and invasion of prostate cancer cells, but for normal PECs, the relationship between them has not been reliably confirmed. Therefore, this research aims to determine the influence of macrophage TvMIF on prostate epithelial cells (PECs) and its preliminary mechanism. The activity of RWPE-1 human normal prostate epithelial cells, the inflammatory response state, the expression of miR-451, and the effect of miR-451 on RWPE-1 were detected after TvMIF intervention. We found that TvMIF can enhance RWPE-1 cell proliferation and activate inflammatory factors by suppressing miR-451, thus taking part in the development and proliferation of diseases such as prostatic hyperplasia and prostatitis.
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Affiliation(s)
- Lin Lin
- School of Medicine, Jiangsu University, Zhenjiang, China
| | - Sheng Xia
- School of Medicine, Jiangsu University, Zhenjiang, China
| | - Wen Zhang
- School of Medicine, Jiangsu University, Zhenjiang, China
| | - Shengxia Chen
- School of Medicine, Jiangsu University, Zhenjiang, China
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7
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Epstein RJ. The secret identities of TMPRSS2: Fertility factor, virus trafficker, inflammation moderator, prostate protector and tumor suppressor. Tumour Biol 2021; 43:159-176. [PMID: 34420994 DOI: 10.3233/tub-211502] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
The human TMPRSS2 gene is pathogenetically implicated in both coronaviral lung infection and prostate cancer, suggesting its potential as a drug target in both contexts. SARS-COV-2 spike polypeptides are primed by the host transmembrane TMPRSS2 protease, triggering virus fusion with epithelial cell membranes followed by an endocytotic internalisation process that bypasses normal endosomal activation of cathepsin-mediated innate immunity; viral co-opting of TMPRSS2 thus favors microbial survivability by attenuating host inflammatory responses. In contrast, most early hormone-dependent prostate cancers express TMPRSS2:ERG fusion genes arising from deletions that eliminate the TMPRSS2 coding region while juxtaposing its androgen-inducible promoter and the open reading frame of ERG, upregulating pro-inflammatory ERG while functionally disabling TMPRSS2. Moreover, inflammatory oxidative DNA damage selects for TMPRSS2:ERG-fused cancers, whereas patients treated with antiinflammatory drugs develop fewer of these fusion-dependent tumors. These findings imply that TMPRSS2 protects the prostate by enabling endosomal bypass of pathogens which could otherwise trigger inflammation-induced DNA damage that predisposes to TMPRSS2:ERG fusions. Hence, the high oncogenic selectability of TMPRSS2:ERG fusions may reflect a unique pro-inflammatory synergy between androgenic ERG gain-of-function and fusogenic TMPRSS2 loss-of-function, cautioning against the use of TMPRSS2-inhibitory drugs to prevent or treat early prostate cancer.
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Affiliation(s)
- Richard J Epstein
- New Hope Cancer Center, Beijing United Hospital, Jiangtai Xi Rd 9-11, Chaoyang, Beijing, China.,Garvan Institute of Medical Research, and UNSW Medical School, St Vincent's Hospital, Victoria St, Darlinghurst, Sydney, Australia
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8
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Platelet-to-lymphocyte ratio is not a predictor of clinically significant prostate cancer at the prostate biopsy: A large cohort study. Sci Rep 2021; 11:14240. [PMID: 34244550 PMCID: PMC8270979 DOI: 10.1038/s41598-021-93637-3] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2021] [Accepted: 06/22/2021] [Indexed: 12/24/2022] Open
Abstract
Previous studies have reported conflicting results on the predictive role of the platelet-to-lymphocyte ratio (PLR) in detecting clinically significant prostate cancer (CSPCa) at the time of prostate biopsies. We explored the predictive value of pre-biopsy PLRs for CSPCa using our large-cohort database. Consecutive men with serum prostate-specific antigen (PSA) levels of ≥ 3.0 ng/mL or abnormal digital rectal examination (DRE) findings and who underwent prostate biopsies were included in the study. There was no significant difference in the pre-biopsy PLR between men with benign disease, clinically insignificant prostate cancer (CISPCa), and CSPCa. Only the subset of CSPCa patients with serum PSA levels of < 10 ng/mL showed lower PLRs than those with benign disease or CISPCa. In the entire patient cohort, multivariate analyses revealed that older age, diabetes mellitus, DRE abnormalities, higher serum PSA levels, and smaller prostate volume were predictors of CSPCa. However, the pre-biopsy PLR was not a significant predictor of CSPCa at the prostate biopsy in the entire patient cohort or the subset of patients with serum PSA levels of < 10 ng/mL. In summary, the pre-biopsy PLR is not an independent predictor of CSPCa at the prostate biopsy, regardless of the serum PSA level.
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Rundle AG, Sadasivan SM, Chitale DA, Gupta NS, Williamson SR, Kryvenko ON, Chen Y, Bobbitt K, Tang D, Rybicki BA. Racial differences in the systemic inflammatory response to prostate cancer. PLoS One 2021; 16:e0252951. [PMID: 34242232 PMCID: PMC8270440 DOI: 10.1371/journal.pone.0252951] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2020] [Accepted: 05/25/2021] [Indexed: 11/19/2022] Open
Abstract
Systemic inflammation may increase risk for prostate cancer progression, but the role it plays in prostate cancer susceptibility is unknown. From a cohort of over 10,000 men who had either a prostate biopsy or transurethral resection that yielded a benign finding, we analyzed 517 incident prostate cancer cases identified during follow-up and 373 controls with one or more white blood cell tests during a follow-up period between one and 18 years. Multilevel, multivariable longitudinal models were fit to two measures of systemic inflammation, neutrophil-to-lymphocyte ratio (NLR) and monocyte-to-lymphocyte ratio (MLR), to determine NLR and MLR trajectories associated with increased risk for prostate cancer. For both measures, we found no significant differences in the trajectories by case/control status, however in modeling NLR trajectories there was a significant interaction between race (white or Black and case-control status. In race specific models, NLR and MLR values were consistently higher over time among white controls than white cases while case-control differences in NLR and MLR trajectories were not apparent among Black men. When cases were classified as aggressive as compared to non-aggressive, the case-control differences in NLR and MLR values over time among white men were most apparent for non-aggressive cases. For NLR among white men, significant case-control differences were observed for the entire duration of observation for men who had inflammation in their initial prostate specimen. It is possible that, among white men, monitoring of NLR and MLR trajectories after an initial negative biopsy may be useful in monitoring prostate cancer risk.
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Affiliation(s)
- Andrew G. Rundle
- Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY, United States of America
| | - Sudha M. Sadasivan
- Department of Public Health Sciences, Henry Ford Hospital, Detroit, MI, United States of America
| | - Dhananjay A. Chitale
- Department of Pathology and Laboratory Medicine, Henry Ford Hospital, Detroit, MI, United States of America
| | - Nilesh S. Gupta
- Department of Pathology and Laboratory Medicine, Henry Ford Hospital, Detroit, MI, United States of America
| | - Sean R. Williamson
- Department of Pathology and Laboratory Medicine, Henry Ford Hospital, Detroit, MI, United States of America
| | - Oleksandr N. Kryvenko
- Department of Pathology and Laboratory Medicine, Department of Urology, and Sylvester Comprehensive Cancer Center, University of Miami Miller School of Medicine, Miami, FL, United States of America
| | - Yalei Chen
- Department of Public Health Sciences, Henry Ford Hospital, Detroit, MI, United States of America
| | - Kevin Bobbitt
- Department of Public Health Sciences, Henry Ford Hospital, Detroit, MI, United States of America
| | - Deliang Tang
- Department of Environmental Health Sciences, Mailman School of Public Health, Columbia Univ., New York, NY, United States of America
| | - Benjamin A. Rybicki
- Department of Public Health Sciences, Henry Ford Hospital, Detroit, MI, United States of America
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10
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Abstract
The relationship between prostatic chronic inflammation (PCI) and prostate cancer (PCa) is unclear and controversial. Some authors reported that a history of chronic prostatitis may be correlated with PCa induction, while others associate chronic inflammation with less aggressive disease or consider inflammation as a possible protective factor against PCa. Four different types of prostatitis are known: bacterial acute prostatic inflammation, bacterial chronic prostatic inflammation, abacterial prostatitis/chronic pelvic pain syndrome, and asymptomatic prostatic chronic inflammation. Prostatic inflammation is underestimated during daily clinical practice, and its presence and degree often go unmentioned in the pathology report of prostate biopsies. The goal of this report is to further our understanding of how PCI influences the biology of PCa. We investigated the main pathogenetic mechanisms responsible for prostatic inflammation, including the cellular response and inflammatory mediators to describe how inflammation modifies the prostatic environment and can lead to benign or malignant prostatic diseases. We found that prostatic inflammation might have a pivotal role in the pathogenesis of prostatic diseases. Details about PCI in all prostate biopsy reports should be mandatory. This will help us better understand the prostatic microenvironment pathways involved in PCa biology, and it will allow the development of specific risk stratification and a patient-tailored therapeutic approach to prostatic diseases.
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11
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Bruno SM, Falagario UG, d'Altilia N, Recchia M, Mancini V, Selvaggio O, Sanguedolce F, Del Giudice F, Maggi M, Ferro M, Porreca A, Sciarra A, De Berardinis E, Bettocchi C, Busetto GM, Cormio L, Carrieri G. PSA Density Help to Identify Patients With Elevated PSA Due to Prostate Cancer Rather Than Intraprostatic Inflammation: A Prospective Single Center Study. Front Oncol 2021; 11:693684. [PMID: 34094990 PMCID: PMC8173030 DOI: 10.3389/fonc.2021.693684] [Citation(s) in RCA: 30] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2021] [Accepted: 04/30/2021] [Indexed: 12/03/2022] Open
Abstract
The association between PSA density, prostate cancer (PCa) and BPH is well established. The aim of the present study was to establish whether PSA density can be used as a reliable parameter to predict csPCa and to determine its optimal cutoff to exclude increased PSA levels due to intraprostatic inflammation. This is a large prospective single-center, observational study evaluating the role of PSA density in the discrimination between intraprostatic inflammation and clinically significant PCa (csPCa). Patients with PSA ≥ 4 ng/ml and/or positive digito-rectal examination (DRE) and scheduled for prostate biopsy were enrolled. Prostatic inflammation (PI) was assessed and graded using the Irani Scores. Multivariable binary logistic regression analysis was used to assess if PSA density was associated with clinically significant PCa (csPCa) rather than prostatic inflammation. A total of 1988 patients met the inclusion criteria. Any PCa and csPCa rates were 47% and 24% respectively. In the group without csPCa, patients with prostatic inflammation had a higher PSA (6.0 vs 5.0 ng/ml; p=0.0003), higher prostate volume (58 vs 52 cc; p<0.0001), were more likely to have a previous negative biopsy (29% vs 21%; p=0.0005) and a negative DRE (70% vs 65%; p=0.023) but no difference in PSA density (0.1 vs 0.11; p=0.2). Conversely in the group with csPCa, patients with prostatic inflammation had a higher prostate volume (43 vs 40 cc; p=0.007) but no difference in the other clinical parameters. At multivariable analysis adjusting for age, biopsy history, DRE and prostate volume, PSA density emerged as a strong predictor of csPCA but was not associated with prostatic inflammation. The optimal cutoffs of PSA density to diagnose csPCa and rule out the presence of prostatic inflammation in patients with an elevated PSA (>4 ng/ml) were 0.10 ng/ml2 in biopsy naïve patients and 0.15 ng/ml2 in patients with a previous negative biopsy. PSA density rather than PSA, should be used to evaluate patients at risk of prostate cancer who may need additional testing or prostate biopsy. This readily available parameter can potentially identify men who do not have PCa but have an elevated PSA secondary to benign conditions.
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Affiliation(s)
- Salvatore M Bruno
- Department of Urology and Renal Transplantation, University of Foggia, Foggia, Italy
| | - Ugo G Falagario
- Department of Urology and Renal Transplantation, University of Foggia, Foggia, Italy
| | - Nicola d'Altilia
- Department of Urology and Renal Transplantation, University of Foggia, Foggia, Italy
| | - Marco Recchia
- Department of Urology and Renal Transplantation, University of Foggia, Foggia, Italy
| | - Vito Mancini
- Department of Urology and Renal Transplantation, University of Foggia, Foggia, Italy
| | - Oscar Selvaggio
- Department of Urology and Renal Transplantation, University of Foggia, Foggia, Italy
| | | | | | - Martina Maggi
- Department of Urology, Sapienza Rome University, Rome, Italy
| | - Matteo Ferro
- Department of Urology, European Institute of Oncology (IEO) IRCCS, Milan, Italy
| | - Angelo Porreca
- Department of Urology, Veneto Institute of Oncology (IOV) IRCCS, Padua, Italy
| | | | | | - Carlo Bettocchi
- Department of Urology and Renal Transplantation, University of Foggia, Foggia, Italy
| | - Gian Maria Busetto
- Department of Urology and Renal Transplantation, University of Foggia, Foggia, Italy
| | - Luigi Cormio
- Department of Urology and Renal Transplantation, University of Foggia, Foggia, Italy
| | - Giuseppe Carrieri
- Department of Urology and Renal Transplantation, University of Foggia, Foggia, Italy
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12
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Langston ME, Sfanos KS, Khan S, Nguyen TQ, De Marzo AM, Platz EA, Sutcliffe S. Why Do Epidemiologic Studies Find an Inverse Association Between Intraprostatic Inflammation and Prostate Cancer: A Possible Role for Colliding Bias? Cancer Epidemiol Biomarkers Prev 2021; 30:255-259. [PMID: 33547143 DOI: 10.1158/1055-9965.epi-20-1009] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2020] [Revised: 10/06/2020] [Accepted: 12/07/2020] [Indexed: 11/16/2022] Open
Abstract
Inflammation is an emerging risk factor for prostate cancer based largely on evidence from animal models and histopathologic observations. However, findings from patho-epidemiologic studies of intraprostatic inflammation and prostate cancer have been less supportive, with inverse associations observed in many studies of intraprostatic inflammation and prostate cancer diagnosis. Here, we propose collider stratification bias as a potential methodologic explanation for these inverse findings and provide strategies for conducting future etiologic studies of intraprostatic inflammation and prostate cancer.
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Affiliation(s)
- Marvin E Langston
- Division of Research, Kaiser Permanente Northern California, Oakland, California.
| | - Karen S Sfanos
- Department of Pathology, Johns Hopkins University School of Medicine, Baltimore, Maryland.,Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins, Baltimore, Maryland.,Department of Urology, James Buchanan Brady Urological Institute, Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Saira Khan
- Epidemiology Program, College of Health Sciences, University of Delaware, Newark, Delaware
| | - Trang Q Nguyen
- Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland
| | - Angelo M De Marzo
- Department of Pathology, Johns Hopkins University School of Medicine, Baltimore, Maryland.,Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins, Baltimore, Maryland.,Department of Urology, James Buchanan Brady Urological Institute, Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Elizabeth A Platz
- Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins, Baltimore, Maryland.,Department of Urology, James Buchanan Brady Urological Institute, Johns Hopkins University School of Medicine, Baltimore, Maryland.,Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland
| | - Siobhan Sutcliffe
- Division of Public Health Sciences, Department of Surgery, Alvin J. Siteman Cancer Center, and Department of Obstetrics and Gynecology, Washington University School of Medicine, St. Louis, Missouri
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13
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Application of Anti-Inflammatory Agents in Prostate Cancer. J Clin Med 2020; 9:jcm9082680. [PMID: 32824865 PMCID: PMC7464558 DOI: 10.3390/jcm9082680] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2020] [Revised: 08/14/2020] [Accepted: 08/17/2020] [Indexed: 02/06/2023] Open
Abstract
Chronic inflammation is a major cause of human cancers. The environmental factors, such as microbiome, dietary components, and obesity, provoke chronic inflammation in the prostate, which promotes cancer development and progression. Crosstalk between immune cells and cancer cells enhances the secretion of intercellular signaling molecules, such as cytokines and chemokines, thereby orchestrating the generation of inflammatory microenvironment. Tumor-associated macrophages (TAMs) and myeloid-derived suppressor cells (MDSCs) play pivotal roles in inflammation-associated cancer by inhibiting effective anti-tumor immunity. Anti-inflammatory agents, such as aspirin, metformin, and statins, have potential application in chemoprevention of prostate cancer. Furthermore, pro-inflammatory immunity-targeted therapies may provide novel strategies to treat patients with cancer. Thus, anti-inflammatory agents are expected to suppress the “vicious cycle” created by immune and cancer cells and inhibit cancer progression. This review has explored the immune cells that facilitate prostate cancer development and progression, with particular focus on the application of anti-inflammatory agents for both chemoprevention and therapeutic approach in prostate cancer.
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14
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Porcaro AB, Tafuri A, Sebben M, Novella G, Processali T, Pirozzi M, Amigoni N, Rizzetto R, Shakir A, Brunelli M, Cerruto MA, Migliorini F, Siracusano S, Artibani W. Elevated prostate volume index and prostatic chronic inflammation reduce the number of positive cores at first prostate biopsy set: results in 945 consecutive patients. Int Braz J Urol 2020; 46:545-556. [PMID: 32213210 PMCID: PMC7239280 DOI: 10.1590/s1677-5538.ibju.2019.0146] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2019] [Accepted: 09/02/2019] [Indexed: 11/22/2022] Open
Abstract
OBJECTIVE To assess the association between prostate volume index (PVI), and prostatic chronic inflammation (PCI) as predictors of prostate cancer (PCA). PVI is the ratio between the central transition zone volume (CTZV) and the peripheral zone volume (PZV). MATERIALS AND METHODS Parameters evaluated included age, prostate specific antigen (PSA), total prostate volume (TPV), PSA density (PSAD), digital rectal exam (DRE), PVI, PCI and number of positive cores (NPC). All patients underwent baseline 14-core, trans-perineal random biopsies. Associations of parameters with the NPC were investigated by univariate and multivariate linear regression analysis. RESULTS Between September 2010 to September 2017, 945 patients were evaluated. PCA was detected in 477 cases (50.7%), PCI in 205 cases (21.7%). PCA patients, compared to negative cases, were older (68.3 vs. 64.4 years) with smaller TPV (36 vs. 48.3mL) and CTZV (19.2 vs. 25.4), higher PSAD (0.24 vs. 0.15ng/mL/mL), further PVI values were lower (0.9 vs. 1.18) and biopsy cores less frequently involved by PCI (9.4% vs. 34.2%). High PVI and the presence of PCI were independent negative predictors of NPC in model I considering PSA and TVP (PVI, regression coefficient, RC -0,6; p=0.002) and PCI (RC -1,4; p<0.0001); and in model II considering PSAD (PVI:RC -0,7; p<0,0001; and PCI: RC -1,5; p<0.0001). CONCLUSIONS High PVI and the presence of PCI lowered the mean rate of NPC and is associated with less aggressive tumor biology expressed by low tumor burden. PVI can give prognostic information before planning baseline random biopsies. Confirmatory studies are required.
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Affiliation(s)
- Antonio B Porcaro
- Department of Urology, University of Verona, Azienda Ospedaliera Universitaria Integrata Verona, Verona, Italy
| | - Alessandro Tafuri
- Department of Urology, University of Verona, Azienda Ospedaliera Universitaria Integrata Verona, Verona, Italy
- USC Institute of Urology, and Catherine and Joseph Aresty, Department of Urology, Keck School of Medicine, University of Southern California (USC), Los Angeles, CA, USA
| | - Marco Sebben
- Department of Urology, University of Verona, Azienda Ospedaliera Universitaria Integrata Verona, Verona, Italy
| | - Giovanni Novella
- Department of Urology, University of Verona, Azienda Ospedaliera Universitaria Integrata Verona, Verona, Italy
| | - Tania Processali
- Department of Urology, University of Verona, Azienda Ospedaliera Universitaria Integrata Verona, Verona, Italy
| | - Marco Pirozzi
- Department of Urology, University of Verona, Azienda Ospedaliera Universitaria Integrata Verona, Verona, Italy
| | - Nelia Amigoni
- Department of Urology, University of Verona, Azienda Ospedaliera Universitaria Integrata Verona, Verona, Italy
| | - Riccardo Rizzetto
- Department of Urology, University of Verona, Azienda Ospedaliera Universitaria Integrata Verona, Verona, Italy
| | - Aliasger Shakir
- USC Institute of Urology, and Catherine and Joseph Aresty, Department of Urology, Keck School of Medicine, University of Southern California (USC), Los Angeles, CA, USA
| | - Matteo Brunelli
- Department of Pathology, University of Verona, Azienda Ospedaliera Universitaria Integrata Verona, Verona, Italy
| | - Maria Angela Cerruto
- Department of Urology, University of Verona, Azienda Ospedaliera Universitaria Integrata Verona, Verona, Italy
| | - Filippo Migliorini
- Department of Urology, University of Verona, Azienda Ospedaliera Universitaria Integrata Verona, Verona, Italy
| | - Salvatore Siracusano
- Department of Urology, University of Verona, Azienda Ospedaliera Universitaria Integrata Verona, Verona, Italy
| | - Walter Artibani
- Department of Urology, University of Verona, Azienda Ospedaliera Universitaria Integrata Verona, Verona, Italy
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15
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Palangmonthip W, Wu R, Tarima S, Bobholz SA, LaViolette PS, Gallan AJ, Iczkowski KA. Corpora amylacea in benign prostatic acini are associated with concurrent, predominantly low-grade cancer. Prostate 2020; 80:687-697. [PMID: 32271960 PMCID: PMC10561550 DOI: 10.1002/pros.23980] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/02/2020] [Revised: 03/09/2020] [Accepted: 03/25/2020] [Indexed: 02/06/2023]
Abstract
BACKGROUND Corpora amylacea (CAM), in benign prostatic acini, contain acute-phase 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.
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Affiliation(s)
- Watchareepohn Palangmonthip
- Department of Pathology, Medical College of Wisconsin, Milwaukee, Wisconsin
- Department of Pathology, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
| | - Ruizhe Wu
- Department of Biostatistics, Medical College of Wisconsin, Milwaukee, Wisconsin
| | - Sergey Tarima
- Department of Biostatistics, Medical College of Wisconsin, Milwaukee, Wisconsin
| | - Samuel A. Bobholz
- Department of Radiology, Medical College of Wisconsin, Milwaukee, Wisconsin
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16
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Tafuri A, Sebben M, Novella G, Pirozzi M, Processali T, Shakir A, Rizzetto R, Amigoni N, Bernasconi R, Brunelli M, Cerruto MA, Siracusano S, Antonelli A, Artibani W, Porcaro AB. Prostatic chronic inflammation and prostate cancer risk at baseline random biopsy: Analysis of predictors. Arab J Urol 2020; 18:148-154. [PMID: 33029424 PMCID: PMC7473292 DOI: 10.1080/2090598x.2020.1757335] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023] Open
Abstract
Objective To evaluate predictors of prostatic chronic inflammation (PCI) and prostate cancer (PCa) in patients undergoing transperineal baseline random prostatic needle biopsies (BNB). Patient and methods According to BNB outcomes, patients were divided into four groups: cases without PCI or PCa (Control group), cases with PCI only (PCI group), cases with PCa and PCI (PCa+PCI group) and cases with PCa only (PCa group). A multinomial logistic regression model was used to evaluate the association of clinical factors with BNB outcomes. Additionally, clinical factors associated with the risk of PCa in the overall population were investigated using a multivariable logistic regression model (univariate and multivariate analysis). Results Overall, 945 patients were evaluated and grouped as follows: Control group, 308 patients (32.6%); PCI group, 160 (16.9%); PCa+PCI group, 45 (4.8%); and PCa group, 432 (45.7%). Amongst these, PCa was independently predicted by age (odds ratio [OR] 1.081), prostate specific-antigen level (PSA; OR 1.159), transition zone volume (TZV; OR 0.916), and abnormal digital rectal examination (DRE; OR 1.962). PCa and PCI (4.8%) were independently predicted by age (OR 1.081), PSA level (OR 1.122) and TZV (OR 0.954). In the group without PCa, the PSA level was the only factor associated with the risk of PCI when compared to the control group (OR 1.051, P = 0.042). Among patients with PCa, independent factors associated with the risk of only PCa compared to cases with PCA+PCI were TZV (OR 0.972) and number of positive cores (OR 1.149). In the overall population, PCI was the strongest predictor of a decreased risk of PCa (multivariate model, OR 0.212; P < 0.001) Conclusions At BNB, PCI was associated with both a decreased risk of PCa and less aggressive tumour biology amongst patients with PCa. The presence of PCI on biopsy cores should be reported because of its implications in clinical practice. Abbreviations BGG: biopsy Gleason Group; BPC: biopsy positive (cancer) cores; BMI: body mass index; FGF-2: fibroblast growth factor 2; IL: interleukin; ISUP: International Society of Urologic Pathology; NIH: National Institutes of Health; OR: odds ratio; PCa: prostate cancer; PCI: prostatic chronic inflammation; TGF: transforming growth factor; TPV: total prostate volume; TZV: transition zone volume
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Affiliation(s)
- Alessandro Tafuri
- Department of Urology, University of Verona, Azienda Ospedaliera Universitaria Integrata Verona, Verona, Italy.,Department of Neuroscience, Imaging and Clinical Science, Physiology and Pathophisiology, "G. D'Annunzio" University, Chieti, Italy.,USC Institute of Urology and Catherine and Joseph Aresty Department of Urology, Keck School of Medicine, University of Southern California (USC), Los Angeles, California, USA
| | - Marco Sebben
- Department of Urology, University of Verona, Azienda Ospedaliera Universitaria Integrata Verona, Verona, Italy
| | - Giovanni Novella
- Department of Urology, University of Verona, Azienda Ospedaliera Universitaria Integrata Verona, Verona, Italy
| | - Marco Pirozzi
- Department of Urology, University of Verona, Azienda Ospedaliera Universitaria Integrata Verona, Verona, Italy
| | - Tania Processali
- Department of Urology, University of Verona, Azienda Ospedaliera Universitaria Integrata Verona, Verona, Italy
| | - Aliasger Shakir
- USC Institute of Urology and Catherine and Joseph Aresty Department of Urology, Keck School of Medicine, University of Southern California (USC), Los Angeles, California, USA
| | - Riccardo Rizzetto
- Department of Urology, University of Verona, Azienda Ospedaliera Universitaria Integrata Verona, Verona, Italy
| | - Nelia Amigoni
- Department of Urology, University of Verona, Azienda Ospedaliera Universitaria Integrata Verona, Verona, Italy
| | - Riccardo Bernasconi
- Department of Pathology, University of Verona, Azienda Ospedaliera Universitaria Integrata Verona, Verona, Italy
| | - Matteo Brunelli
- Department of Pathology, University of Verona, Azienda Ospedaliera Universitaria Integrata Verona, Verona, Italy
| | - Maria A Cerruto
- Department of Urology, University of Verona, Azienda Ospedaliera Universitaria Integrata Verona, Verona, Italy
| | - Salvatore Siracusano
- Department of Urology, University of Verona, Azienda Ospedaliera Universitaria Integrata Verona, Verona, Italy
| | - Alessandro Antonelli
- Department of Urology, University of Verona, Azienda Ospedaliera Universitaria Integrata Verona, Verona, Italy
| | - Walter Artibani
- Department of Urology, University of Verona, Azienda Ospedaliera Universitaria Integrata Verona, Verona, Italy
| | - Antonio B Porcaro
- Department of Urology, University of Verona, Azienda Ospedaliera Universitaria Integrata Verona, Verona, Italy
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17
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Sanguedolce F, Falagario UG, Castellan P, Di Nauta M, Silecchia G, Bruno SM, Russo D, Treacy PJ, Tewari AK, Montironi R, Carrieri G, Cormio L. Bioptic intraprostatic chronic inflammation predicts adverse pathology at radical prostatectomy in patients with low-grade prostate cancer. Urol Oncol 2020; 38:793.e19-793.e25. [PMID: 32220548 DOI: 10.1016/j.urolonc.2020.02.025] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2019] [Revised: 02/02/2020] [Accepted: 02/22/2020] [Indexed: 02/06/2023]
Abstract
PURPOSE To determine the potential role of bioptic inflammation (Irani score) in predicting adverse pathology (AP) at radical prostatectomy (RP) in patients with low-grade (ISUP Gleason Group [ISUP GG] 1 and 2) prostate cancer (CaP). METHODS After institutional review board-approval, we identified patients who underwent prostate biopsy, had bioptic Irani score assessment, were diagnosed with low-grade CaP (ISUP GG 1-2, prostate-specific antigen [PSA] <20 ng/ml), and underwent RP. The impact of standard clinicopathological variables and bioptic Irani Score (G = grade and A = aggressiveness) on AP at RP, defined as stage ≥T3 and/or ISUP GG ≥3, was assessed by univariate and multivariate logistic regression analysis. RESULTS A total of 282 patients were eligible for this study. AP at RP occurred in 37 of 214 (17.3%) patients with ISUP GG 1, and 26 of 68 (38.2%) with ISUP GG 2. At univariate analysis, serum PSA, PSA density, bioptic ISUP GG, number of positive cores, total percentage of core involvement and Irani G score emerged as significant risk factors of AP. At multivariate analysis, however, only PSA density, bioptic ISUP GG, total percentage of core, and Irani G score kept statistical significance. The area under the curve for the resulting model was 0.75. CONCLUSIONS This is the first study demonstrating that low-grade inflammation is associated with a significantly increased risk of AP at RP. These findings would support the concept of prostatic inflammation being inversely correlated with presence and aggressiveness of CaP. Further studies are needed to externally validate the role of this readily available parameter in the decision-making process of patients with low-grade CaP.
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Affiliation(s)
| | - Ugo Giovanni Falagario
- Department of Urology and Organ Transplantation, University of Foggia, Foggia, Italy; Department of Urology, Icahn school of medicine at Mount Sinai, New York City, NY.
| | | | - Michele Di Nauta
- Department of Urology and Organ Transplantation, University of Foggia, Foggia, Italy
| | - Giovanni Silecchia
- Department of Urology and Organ Transplantation, University of Foggia, Foggia, Italy
| | - Salvatore M Bruno
- Department of Urology and Organ Transplantation, University of Foggia, Foggia, Italy
| | - Davide Russo
- Department of Pathology, University of Foggia, Foggia, Italy
| | | | - Ashutosh K Tewari
- Department of Urology, Icahn school of medicine at Mount Sinai, New York City, NY
| | - Rodolfo Montironi
- Institute of Pathological Anatomy and Histopathology, School of Medicine, Polytechnic University of the Marche Region (Ancona), United Hospitals, Ancona, Italy
| | - Giuseppe Carrieri
- Department of Urology and Organ Transplantation, University of Foggia, Foggia, Italy
| | - Luigi Cormio
- Department of Urology and Organ Transplantation, University of Foggia, Foggia, Italy
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18
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Langston ME, Horn M, Khan S, Pakpahan R, Doering M, Dennis LK, Sutcliffe S. A Systematic Review and Meta-analysis of Associations between Clinical Prostatitis and Prostate Cancer: New Estimates Accounting for Detection Bias. Cancer Epidemiol Biomarkers Prev 2019; 28:1594-1603. [PMID: 31337640 DOI: 10.1158/1055-9965.epi-19-0387] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2019] [Revised: 06/25/2019] [Accepted: 07/17/2019] [Indexed: 01/09/2023] Open
Abstract
BACKGROUND Previous meta-analyses have estimated summary positive associations between clinical prostatitis and prostate cancer. However, none have accounted for detection bias, the possibility for increased prostate cancer screening and detection in men with clinical prostatitis, in their pooled estimates. METHODS We searched for studies that investigated the relation between clinical prostatitis and prostate cancer through November 2018. Random effects meta-analysis was used to calculate summary odds ratios (OR) among all studies and in strata defined by methods used to reduce detection bias.Results: Although an increased odds of prostate cancer was seen among men with a history of clinical prostatitis in all 38 eligible studies combined [OR, 2.05; 95% confidence interval (CI), 1.64-2.57], this estimate attenuated to null among studies that performed the most rigorous analyses to limit detection bias (OR, 1.16; 95% CI, 0.77-1.74). CONCLUSIONS Our findings indicate that previously reported positive associations between clinical prostatitis and prostate cancer are likely due to detection bias. IMPACT Studies using rigorous detection bias methods are warranted to replicate these findings, as well as to examine the possible relation between prostate inflammation and prostate cancer directly, rather than indirectly through the diagnosis of "prostatitis," which includes a large proportion of men without evidence of prostate inflammation.
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Affiliation(s)
- Marvin E Langston
- Division of Public Health Sciences, Department of Surgery, Washington University School of Medicine, St. Louis, Missouri.
| | - Mara Horn
- Division of Public Health Sciences, Department of Surgery, Washington University School of Medicine, St. Louis, Missouri
| | - Saira Khan
- Division of Public Health Sciences, Department of Surgery, Washington University School of Medicine, St. Louis, Missouri.,Epidemiology Program, College of Health Sciences, University of Delaware, Newark, Delaware
| | - Ratna Pakpahan
- Division of Public Health Sciences, Department of Surgery, Washington University School of Medicine, St. Louis, Missouri
| | - Michelle Doering
- Becker Medical Library, Washington University School of Medicine, St. Louis, Missouri
| | - Leslie K Dennis
- Department of Epidemiology and Biostatistics, Mel and Enid Zuckerman College of Public Health, University of Arizona, Tucson, Arizona
| | - Siobhan Sutcliffe
- Division of Public Health Sciences, Department of Surgery, Washington University School of Medicine, St. Louis, Missouri.,Alvin J. Siteman Cancer Center, Department of Surgery, Washington University School of Medicine, St. Louis, Missouri
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19
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Prostate volume index and prostatic chronic inflammation predicted low tumor load in 945 patients at baseline prostate biopsy. World J Urol 2019; 38:957-964. [PMID: 31154465 DOI: 10.1007/s00345-019-02830-7] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2019] [Accepted: 05/28/2019] [Indexed: 10/26/2022] Open
Abstract
PURPOSE To assess associations of prostate volume index (PVI), defined as the ratio of the volume of the central transition zone to the volume of the peripheral zone of the prostate and prostatic chronic inflammation (PCI) as predictors of tumor load by number of positive cores (PC) in patients undergoing baseline random biopsies. METHODS Parameters evaluated included age, PSA, total prostate volume, PSA density, digital rectal exam, PVI, and PCI. All patients underwent standard transperineal random biopsies. Tumor load was evaluated as absent (no PC), limited (1-3 PC), and extensive (more than 3 PC). The association of factors with the risk of tumor load was evaluated by the multinomial logistic regression model. RESULTS The study evaluated 945 patients. Cancer PC were detected in 477 (507%) cases of whom 207 (43.4%) had limited tumor load and 270 (56.6%) had extensive tumor load. Among other factors, comparing patients with limited tumor load with negative cases, PVI [odds ratio, OR = 0.521, 95% confidence interval (CI) 0.330-0.824; p < 0.005] and PCI (OR = 0.289, 95% CI 0.180-0.466; p < 0.0001) were inversely associated with the PCA risk. Comparing patients with extensive tumor load with negative patients, PVI (OR = 0.579, 95% CI 0.356-0.944; p = 0.028), and PCI (OR = 0.150, 95% CI 0.085-0.265; p < 0.0001), predicted PCA risk. Comparing extensive tumor load with limited tumor load patients, PVI and PCI did not show any association with the tumor load. CONCLUSIONS Increased PVI and the presence of PCI decreased the risk of increased tumor load and associated with less aggressive prostate cancer biology in patients at baseline random biopsies.
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20
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Porcaro AB, Tafuri A, Sebben M, Shakir A, Novella G, Pirozzi M, Processali T, Rizzetto R, Amigoni N, Tiso L, Cerrato C, Brunelli M, Cerruto MA, Migliorini F, Siracusano S, Artibani W. Prostate volume index and prostatic chronic inflammation have an effect on tumor load at baseline random biopsies in patients with normal DRE and PSA values less than 10 ng/ml: results of 564 consecutive cases. Ther Adv Urol 2019; 11:1756287219868604. [PMID: 31452688 PMCID: PMC6696840 DOI: 10.1177/1756287219868604] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2019] [Accepted: 07/15/2019] [Indexed: 02/03/2023] Open
Abstract
BACKGROUND To assess the association of prostate volume index (PVI), defined as the ratio of the central transition zone volume (CTZV) to the peripheral zone volume (PZV), and prostatic chronic inflammation (PCI) as predictors of prostate cancer (PCA) load in patients presenting with normal digital rectal exam (DRE) and prostate-specific antigen (PSA) ⩽ 10 ng/ml at baseline random biopsies. METHODS Parameters evaluated included age, PSA, total prostate volume (TPV), PSA density (PSAD), PVI and PCI. All patients underwent 14 core transperineal randomized biopsies. We considered small and high PCA load patients with no more than three (limited tumor load) and greater than three (extensive tumor load) positive biopsy cores, respectively. The association of factors with the risk of PCA was evaluated by logistic regression analysis, utilizing different multivariate models. RESULTS 564 Caucasian patients were included. PCA and PCI were detected in 242 (42.9%) and 129 (22.9%) cases, respectively. On multivariate analysis, PVI and PCI were independent predictors of the risk of detecting limited or extensive tumor load. The risk of detecting extensive tumor load at baseline biopsies was increased by PSAD above the median and third quartile as well as PVI ⩽ 1 [odds ratio (OR)=1.971] but decreased by PCI (OR=0.185; 95% CI: 0.088-0.388). CONCLUSIONS Higher PVI and the presence of PCI predicted decreased PCA risk in patients presenting with normal DRE, and a PSA ⩽ 10 ng/ml at baseline random biopsy. In this subset of patients, a PVI ⩽ or >1 is able to differentiate patients with PCA or PCI.
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Affiliation(s)
- Antonio B. Porcaro
- Department of Urology, Azienda Ospedaliera Universitaria Integrata Verona, Piazzale Stefani 1, 37126, Verona, Italy
| | - Alessandro Tafuri
- Department of Urology, University of Verona, Verona, Italy
- USC Institute of Urology and Catherine and Joseph Aresty Department of Urology, University of Southern California, Los Angeles, California, USA
| | - Marco Sebben
- Department of Urology, University of Verona, Verona, Italy
| | - Aliasger Shakir
- USC Institute of Urology and Catherine and Joseph Aresty Department of Urology, University of Southern California, Los Angeles, CA, USA
| | | | - Marco Pirozzi
- Department of Urology, University of Verona, Verona, Italy
| | | | | | - Nelia Amigoni
- Department of Urology, University of Verona, Verona, Italy
| | - Leone Tiso
- Department of Urology, University of Verona, Verona, Italy
| | - Clara Cerrato
- Department of Urology, University of Verona, Verona, Italy
| | - Matteo Brunelli
- Department of Pathology, University of Verona, Verona, Italy
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21
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Wang H, Han R. Zinc as a modulator of membrane stability parameters during prostate cancer. MINERVA BIOTECNOL 2018. [DOI: 10.23736/s1120-4826.18.02427-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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22
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Kim SH, Park B, Joung JY, Chung J, Seo HK, Lee KH, Park WS. Retrospective Study of the Significant Predictive Role of Inflammatory Degree in Initial and Repeat Prostate Biopsy Specimens for Detecting Prostate Cancer. Cancer Res Treat 2018; 51:910-918. [PMID: 30282448 PMCID: PMC6639219 DOI: 10.4143/crt.2018.314] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2018] [Accepted: 10/01/2018] [Indexed: 11/26/2022] Open
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.
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Affiliation(s)
- Sung Han Kim
- Department of Urology, Center for Prostate Cancer, National Cancer Center, Goyang, Korea
| | - Boram Park
- Biostatistics Collaboration Unit, Research Institute, National Cancer Center, Goyang, Korea
| | - Jae Young Joung
- Department of Urology, Center for Prostate Cancer, National Cancer Center, Goyang, Korea
| | - Jinsoo Chung
- Department of Urology, Center for Prostate Cancer, National Cancer Center, Goyang, Korea
| | - Ho Kyung Seo
- Department of Urology, Center for Prostate Cancer, National Cancer Center, Goyang, Korea
| | - Kang Hyun Lee
- Department of Urology, Center for Prostate Cancer, National Cancer Center, Goyang, Korea
| | - Weon Seo Park
- Department of Pathology, Center for Prostate Cancer, National Cancer Center, Goyang, Korea
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23
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Kuang AG, Nickel JC, Andriole GL, Castro-Santamaria R, Freedland SJ, Moreira DM. Both acute and chronic inflammation are associated with less perineural invasion in men with prostate cancer on repeat biopsy. BJU Int 2018; 123:91-97. [PMID: 29873889 DOI: 10.1111/bju.14428] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
OBJECTIVES To evaluate the association between acute and chronic inflammation with the presence of perineural invasion (PNI) in prostate biopsies positive for prostate cancer (PCa). MATERIAL AND METHODS We conducted a retrospective analysis of 1 399 prostate biopsies positive for PCa in the Reduction by Dutasteride of PCa Events (REDUCE) study. PCa, acute and chronic prostate inflammation and PNI were assessed by central pathology review. The association between acute and chronic inflammation with PNI was evaluated using chi-squared and Kruskal-Wallis tests, and logistic regression adjusting for clinicopathological and biochemical variables. RESULTS The presence of PNI was identified in 133 biopsies (9.5%). In all, 267 biopsies (19.1%) had acute inflammation, 1 038 (74.2%) had chronic inflammation, and 255 (18.2%) had both. The presence of both acute and chronic inflammation had a mutual association (P < 0.001). Chronic inflammation was associated with a lower Gleason score (P = 0.009) and lower tumour volume (P < 0.001), while acute inflammation was associated with lower Gleason score (P = 0.04), lower tumour volume (P = 0.004) and higher prostate-specific antigen levels (P = 0.05). In both univariable and multivariable analyses, chronic prostate inflammation was significantly associated with less PNI (univariable odds ratio [OR] 0.54, 95% confidence interval [CI] 0.37-0.79, P = 0.001; multivariable OR 0.65, 95% CI 0.43-0.99, P = 0.045). Acute prostate inflammation was associated with less PNI only in univariable analysis (univariable OR 0.51, 95% CI 0.29-0.89, P = 0.018; multivariable OR 0.63, 95% CI 0.35-1.13, P = 0.12). CONCLUSION Acute and chronic prostate inflammation were both associated with a lower prevalence of PNI in prostate biopsies positive for PCa. If confirmed, this suggests that inflammation and immunomodulation can serve as areas of potential therapeutic design to mitigate PNI in patients with PCa.
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Affiliation(s)
- Andrew G Kuang
- Department of Urology, University of Illinois at Chicago, Chicago, IL, USA
| | - J Curtis Nickel
- Department of Urology, Queen's University, Kingston, ON, Canada
| | - Gerald L Andriole
- Division of Urologic Surgery, Department of Surgery, Washington University School of Medicine, St Louis, MO, USA
| | | | - Stephen J Freedland
- Division of Urology, Department of Surgery, Cedars-Sinai Medical Center, Los Angeles, CA, USA.,Section of Urology Durham VA Medical Center, Durham, NC, USA
| | - Daniel M Moreira
- Department of Urology, University of Illinois at Chicago, Chicago, IL, USA
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24
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Banzola I, Mengus C, Wyler S, Hudolin T, Manzella G, Chiarugi A, Boldorini R, Sais G, Schmidli TS, Chiffi G, Bachmann A, Sulser T, Spagnoli GC, Provenzano M. Expression of Indoleamine 2,3-Dioxygenase Induced by IFN-γ and TNF-α as Potential Biomarker of Prostate Cancer Progression. Front Immunol 2018; 9:1051. [PMID: 29896191 PMCID: PMC5986916 DOI: 10.3389/fimmu.2018.01051] [Citation(s) in RCA: 51] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2018] [Accepted: 04/27/2018] [Indexed: 12/22/2022] Open
Abstract
Inflammation has been suggested to play an important role in onset and progression of prostate cancer (PCa). Histological analysis of prostatectomy specimens has revealed focal inflammation in early stage lesions of this malignancy. We addressed the role of inflammatory stimuli in the release of PCa-specific, tumor-derived soluble factors (PCa-TDSFs) already reported to be mediators of PCa morbidity, such as indoleamine 2,3-dioxygenase (IDO) and interleukin (IL)-6. Inflammation-driven production and functions of PCa-TDFSs were tested "in vitro" by stimulating established cell lines (CA-HPV-10 and PC3) with IFN-γ or TNF-α. Expression of genes encoding IDO, IL-6, IFN-γ, TNF-α, and their receptors was investigated in tumor tissues of PCa patients undergoing radical prostatectomy, in comparison with benign prostatic hyperplasia (BPH) specimens. IFN-γ and TNF-α-treatment resulted in the induction of IDO and IL-6 gene expression and release in established cell lines, suggesting that the elicitation of PCa-TDSFs by these cytokines might contribute to progression of cancer into an untreatable phenotype. An analysis based on timing of biochemical recurrence revealed the prognostic value of IDO but not IL-6 gene expression in predicting recurrence-free survival in patients (RFS) with PCa. In addition, a urine-based mRNA biomarker study revealed the diagnostic potential of IDO gene expression in urines of men at risk of PCa development.
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Affiliation(s)
- Irina Banzola
- Oncology Research Unit, Department of Urology, University Hospital of Zurich, Zurich, Switzerland
- Department of Oncology and Children’s Research Center (CRC), University Children’s Hospital, Zurich, Switzerland
| | - Chantal Mengus
- Department of Biomedicine, University Hospital of Basel, Basel, Switzerland
| | - Stephen Wyler
- Department of Urology, University Hospital of Basel, Basel, Switzerland
| | - Tvrko Hudolin
- Department of Urology, University Hospital of Basel, Basel, Switzerland
| | - Gabriele Manzella
- Department of Oncology and Children’s Research Center (CRC), University Children’s Hospital, Zurich, Switzerland
| | - Alberto Chiarugi
- Department of Preclinical and Clinical Pharmacology, University of Florence, Florence, Italy
| | - Renzo Boldorini
- Department of Health Science, School of Medicine, Università degli Studi del Piemonte Orientale, Novara, Italy
| | - Giovanni Sais
- Oncology Research Unit, Department of Urology, University Hospital of Zurich, Zurich, Switzerland
| | - Tobias S. Schmidli
- Oncology Research Unit, Department of Urology, University Hospital of Zurich, Zurich, Switzerland
| | - Gabriele Chiffi
- Oncology Research Unit, Department of Urology, University Hospital of Zurich, Zurich, Switzerland
| | | | - Tullio Sulser
- Oncology Research Unit, Department of Urology, University Hospital of Zurich, Zurich, Switzerland
| | - Giulio C. Spagnoli
- Department of Biomedicine, University Hospital of Basel, Basel, Switzerland
- CNR Institute of Translational Pharmacology, Rome, Italy
| | - Maurizio Provenzano
- Oncology Research Unit, Department of Urology, University Hospital of Zurich, Zurich, Switzerland
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25
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Guo Y, Liu B, Liu J, Wang S, Wang R, Chang R, Sun W, Ma T, Li Q. Serum and tissue monocyte differentiation in PSA value 4–10 ng/mL prostate cancer and benign prostatic hyperplasia. EUR J INFLAMM 2018. [DOI: 10.1177/2058739218812665] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Increased serum prostate-specific antigen (PSA) level is closely associated with prostate cancer; however, there is still no reliable method for distinguishing prostate cancer from benign prostatic hyperplasia (BPH) when the PSA level is between 4 and 10 ng/mL. In this study, we detected the inflammatory cell counts in serum and prostate tissues in prostate cancer and BPH patients. The results showed that the monocyte counts in both serum and prostate tissues were obviously less in patients with prostate cancer than that in those with BPH, which indicates that monocyte may be associated with development of prostate cancer and it is possible to increase positive finding for prostate cancer with 4–10 ng/mL PSA concentration by detecting and analyzing monocyte count in serum and tissue simultaneously.
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Affiliation(s)
- Yuanyuan Guo
- Department of Urology, First Affiliated Hospital of Bengbu Medical College, Bengbu, China
| | - Beibei Liu
- Department of Urology, First Affiliated Hospital of Bengbu Medical College, Bengbu, China
| | - Jianmin Liu
- Department of Urology, First Affiliated Hospital of Bengbu Medical College, Bengbu, China
| | - Sheng Wang
- Department of Urology, First Affiliated Hospital of Bengbu Medical College, Bengbu, China
| | - Rui Wang
- Department of Medical Oncology, First Affiliated Hospital of Bengbu Medical College, Bengbu, China
| | - Rui Chang
- Department of Urology, First Affiliated Hospital of Bengbu Medical College, Bengbu, China
| | - Wenyan Sun
- Department of Urology, First Affiliated Hospital of Bengbu Medical College, Bengbu, China
| | - Tantu Ma
- Department of Urology, First Affiliated Hospital of Bengbu Medical College, Bengbu, China
| | - Qingwen Li
- Department of Urology, First Affiliated Hospital of Bengbu Medical College, Bengbu, China
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