Skip to main content

Advertisement

SpringerLink
Log in

Is histological prostate inflammation in an initial prostate biopsy a predictor of prostate cancer on repeat biopsy?

  • Urology - Original Paper
  • Published:
International Urology and Nephrology Aims and scope Submit manuscript

Abstract

Purpose

To investigate whether histological inflammation detected in an initial prostate biopsy can predict the risk of prostate cancer on a repeat biopsy.

Methods

This was a retrospective study of 171 patients who underwent repeat prostate biopsy for persistently elevated prostate-specific antigen after an initial negative biopsy result. The enrolled patients were divided into two groups according to the results of the repeat biopsy: the noncancer group (n = 126) and the cancer group (n = 45). Multivariate regression analysis was used to determine the effect of inflammation grade, aggressiveness, and prostate-related parameters on the detection of prostate cancer at the repeat biopsy.

Results

Prostate inflammation grade (p = 0.005) and aggressiveness (p = 0.001) in the initial biopsy were significantly different between the cancer and noncancer groups. Factors associated with the risk of prostate cancer at the repeat biopsy were age [odds ratio (OR) 1.08; 95 % confidence interval (CI) 1.03–1.14], prostate-specific antigen density (OR 24.30; 95 % CI 9.3–62.9), prostate-specific antigen velocity (OR 1.05; 95 % CI 1.01–1.09), and inflammation aggressiveness (OR 0.05; 95 % CI 0.01–0.27).

Conclusions

A histological inflammatory finding at the initial prostate biopsy was negatively associated with prostate cancer detection in repeat biopsy. This result could be useful to determine the need for repeat prostate biopsy in patients with persistently elevated prostate-specific antigen.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. Roberts RO, Bergstralh EJ, Lieber MM, Jacobsen SJ (2000) Digital rectal examination and prostate-specific antigen abnormalities at the time of prostate biopsy and biopsy outcomes, 1980 to 1997. Urology 56:817–822

    Article  CAS  PubMed  Google Scholar 

  2. Littrup PJ, Bailey SE (2000) Prostate cancer: the role of transrectal ultrasound and its impact on cancer detection and management. Radiol Clin N Am 38:87–113

    Article  CAS  PubMed  Google Scholar 

  3. Roehl KA, Antenor JA, Catalona WJ (2002) Serial biopsy results in prostate cancer screening study. J Urol 167:2435–2439

    Article  PubMed  Google Scholar 

  4. Nam RK, Saskin R, Lee Y et al (2010) Increasing hospital admission rates for urological complications after transrectal ultrasound guided prostate biopsy. J Urol 183:963–968

    Article  PubMed  Google Scholar 

  5. Partin AW, Carter HB, Chan DW et al (1990) Prostate specific antigen in the staging of localized prostate cancer: influence of tumor differentiation, tumor volume and benign hyperplasia. J Urol 143:747–752

    CAS  PubMed  Google Scholar 

  6. Nadler RB, Humphrey PA, Smith DS, Catalona WJ, Ratliff TL (1995) Effect of inflammation and benign prostatic hyperplasia on elevated serum prostate specific antigen levels. J Urol 154:407–413

    Article  CAS  PubMed  Google Scholar 

  7. Cohen RJ, Shannon BA, McNeal JE, Shannon T, Garrett KL (2005) Propionibacterium acnes associated with inflammation in radical prostatectomy specimens: a possible link to cancer evolution? J Urol 173:1969–1974

    Article  PubMed  Google Scholar 

  8. Nickel JC, True LD, Krieger JN, Berger RE, Boag AH, Young ID (2001) Consensus development of a histopathological classification system for chronic prostatic inflammation. BJU Int 87:797–805

    Article  CAS  PubMed  Google Scholar 

  9. Irani J, Levillain P, Goujon JM, Bon D, Doré B, Aubert J (1997) Inflammation in benign prostatic hyperplasia: correlation with prostate specific antigen value. J Urol 157:1301–1303

    Article  CAS  PubMed  Google Scholar 

  10. Fleshner NE, O’Sullivan M, Fair WR (1997) Prevalence and predictors of a positive repeat transrectal ultrasound guided needle biopsy of the prostate. J Urol 158:505–508

    Article  CAS  PubMed  Google Scholar 

  11. Noguchi M, Yahara J, Koga H, Nakashima O, Noda S (1999) Necessity of repeat biopsies in men for suspected prostate cancer. Int J Urol 6:7–12

    Article  CAS  PubMed  Google Scholar 

  12. Durkan GC, Greene DR (1999) Elevated serum prostate specific antigen levels in conjunction with an initial prostatic biopsy negative for carcinoma: who should undergo a repeat biopsy? BJU Int 83:34–38

    Article  CAS  PubMed  Google Scholar 

  13. Merrimen JL, Jones G, Walker D, Leung CS, Kapusta LR, Srigley JR (2009) Multifocal high grade prostatic intraepithelial neoplasia is a significant risk factor for prostatic adenocarcinoma. J Urol 182:485–490

    Article  PubMed  Google Scholar 

  14. Lee JG, Bae SH, Choi SH, Kwon TG, Kim TH (2012) Role of prostate-specific antigen change ratio at initial biopsy as a novel decision-making marker for repeat prostate biopsy. Korean J Urol 53:467–471

    Article  PubMed Central  PubMed  Google Scholar 

  15. Catalona WJ, Partin AW, Slawin KM et al (1998) Use of the percentage of free prostate-specific antigen to enhance differentiation of prostate cancer from benign prostatic disease: a prospective multicenter clinical trial. JAMA 279:1542–1547

    Article  CAS  PubMed  Google Scholar 

  16. Morgan TO, McLeod DG, Leifer ES, Murphy GP, Moul JW (1996) Prospective use of free prostate-specific antigen to avoid repeat prostate biopsies in men with elevated total prostate-specific antigen. Urology 48:76–80

    Article  CAS  PubMed  Google Scholar 

  17. Vignozzi L, Maggi M (2014) Prostate cancer: intriguing data on inflammation and prostate cancer. Nat Rev Urol 11:369–370

    Article  PubMed  Google Scholar 

  18. Corona G, Vignozzi L, Rastrelli G, Lotti F, Cipriani S, Maggi M (2014) Benign prostatic hyperplasia: a new metabolic disease of the aging male and its correlation with sexual dysfunctions. Int J Endocrinol 2014:329456

    PubMed Central  PubMed  Google Scholar 

  19. Brawer MK, Rennels MA, Nagle RB, Schifman R, Gaines JA (1989) Serum prostate-specific antigen and prostate pathology in men having simple prostatectomy. Am J Clin Pathol 92:760–764

    CAS  PubMed  Google Scholar 

  20. Schatteman PH, Hoekx L, Wyndaele JJ, Jeuris W, Van Marck E (2000) Inflammation in prostate biopsies of men without prostatic malignancy or clinical prostatitis: correlation with total serum PSA and PSA density. Eur Urol 37:404–412

    Article  CAS  PubMed  Google Scholar 

  21. Kandirali E, Boran C, Serin E, Semercioz A, Metin A (2007) Association of extent and aggressiveness of inflammation with serum PSA levels and PSA density in asymptomatic patients. Urology 70:743–747

    Article  PubMed  Google Scholar 

  22. Kim HW, Kim SH, Kim SW, Jung KI, Min KO, Cho SY (2009) Effects of subclinical prostatitis on benign prostatic hyperplasia. Korean J Urol 50:154–158

    Article  Google Scholar 

  23. Park CH, Kim SJ, Park CM, Kim HK, Park JY (2009) The influence of prostate chronic inflammation on parameters related to prostate cancer in asymptomatic patients. Korean J Urol Oncol 7:74–81

    Google Scholar 

  24. Terakawa T, Miyake H, Kanomata N, Kumano M, Takenaka A, Fujisawao M (2008) Inverse association between histologic inflammation in needle biopsy specimens and prostate cancer in men with serum PSA of 10–50 ng/mL. Urology 72:1194–1197

    Article  PubMed  Google Scholar 

  25. Pepe P, Aragona F (2011) Does an inflammatory pattern at primary biopsy suggest a lower risk for prostate cancer at repeated saturation prostate biopsy? Urol Int 87:171–174

    Article  PubMed  Google Scholar 

  26. Gurel B, Lucia MS, Thompson IM Jr et al (2014) Chronic inflammation in benign prostate tissue is associated with high-grade prostate cancer in the placebo arm of the prostate cancer prevention trial. Cancer Epidemiol Biomark Prev 23:847–856

    Article  Google Scholar 

  27. Fujita K, Hosomi M, Tanigawa G, Okumi M, Fushimi H, Yamaguchi S (2011) Prostatic inflammation detected in initial biopsy specimens and urinary pyuria are predictors of negative repeat prostate biopsy. J Urol 185:1722–1727

    Article  PubMed  Google Scholar 

  28. Moreira DM, Nickel JC, Gerber L et al (2014) Baseline prostate inflammation is associated with a reduced risk of prostate cancer in men undergoing repeat prostate biopsy: results from the REDUCE study. Cancer 120:190–196

    Article  CAS  PubMed  Google Scholar 

  29. Yli-Hemminki TH, Laurila M, Auvinen A et al (2013) Histological inflammation and risk of subsequent prostate cancer among men with initially elevated serum prostate-specific antigen (PSA) concentration in the Finnish prostate cancer screening trial. BJU Int 112:735–741

    Article  CAS  PubMed  Google Scholar 

  30. Delongchamps NB, de la Roza G, Chandan V et al (2008) Evaluation of prostatitis in autopsied prostates-is chronic inflammation more associated with benign prostatic hyperplasia or cancer? J Urol 179:1736–1740

    Article  PubMed Central  PubMed  Google Scholar 

Download references

Conflict of interest

No potential conflict of interest relevant to this article was reported.

Ethical standards

This study protocol was reviewed and approved by the institutional review board (IRB Registration No. CNUHH-2015-030).

Informed consent

Informed consent was waived by the board.

Author information

Author notes

    Authors and Affiliations

    1. Department of Urology, Chonnam National University Medical School, 42, Jebong-ro, Donggu, Gwangju, 501-757, Republic of Korea

      Bu Hyeon Yun, Eu Chang Hwang, Ho Song Yu, Hoseok Chung, Sun-Ouck Kim, Seung Il Jung, Taek won Kang, Dong Deuk Kwon & Kwangsung Park

    2. Department of Pathology, Chonnam National University Medical School, Gwangju, Republic of Korea

      Chan Choi

    Authors
    1. Bu Hyeon Yun
      View author publications

      You can also search for this author in PubMed Google Scholar

    2. Eu Chang Hwang
      View author publications

      You can also search for this author in PubMed Google Scholar

    3. Ho Song Yu
      View author publications

      You can also search for this author in PubMed Google Scholar

    4. Hoseok Chung
      View author publications

      You can also search for this author in PubMed Google Scholar

    5. Sun-Ouck Kim
      View author publications

      You can also search for this author in PubMed Google Scholar

    6. Seung Il Jung
      View author publications

      You can also search for this author in PubMed Google Scholar

    7. Taek won Kang
      View author publications

      You can also search for this author in PubMed Google Scholar

    8. Dong Deuk Kwon
      View author publications

      You can also search for this author in PubMed Google Scholar

    9. Kwangsung Park
      View author publications

      You can also search for this author in PubMed Google Scholar

    10. Chan Choi
      View author publications

      You can also search for this author in PubMed Google Scholar

    Corresponding author

    Correspondence to Kwangsung Park.

    Additional information

    Bu Hyeon Yun and Eu Chang Hwang have contributed equally to this work.

    Rights and permissions

    Reprints and permissions

    About this article

    Check for updates. Verify currency and authenticity via CrossMark

    Cite this article

    Yun, B.H., Hwang, E.C., Yu, H.S. et al. Is histological prostate inflammation in an initial prostate biopsy a predictor of prostate cancer on repeat biopsy?. Int Urol Nephrol 47, 1251–1257 (2015). https://doi.org/10.1007/s11255-015-1029-6

    Download citation

    • Received:

    • Accepted:

    • Published:

    • Issue Date:

    • DOI: https://doi.org/10.1007/s11255-015-1029-6

    Keywords

    Search

    Navigation