Racial variation in the outcome of subsequent prostate biopsies in men with an initial diagnosis of atypical small acinar proliferation (ASAP).

2016 ◽  
Vol 34 (2_suppl) ◽  
pp. 141-141
Author(s):  
Jordan J. Kramer ◽  
Robert Scott Libby ◽  
Allison H. Feibus ◽  
Nora M. Haney ◽  
Ian R. McCaslin ◽  
...  
Keyword(s):  
Prostate Biopsy ◽  
Medical Center ◽  
Specific Antigen ◽  
Low Grade ◽  
Veterans Health ◽  
Initial Finding ◽  
Racial Variation ◽  
Atypical Small Acinar Proliferation ◽  
Prostate Biopsies ◽  
Increased Risk

141 Background: African Americans (AA) are known to have more aggressive prostate cancer (PCa) and a greater probability of death from PCa. We sought to determine predictors of subsequent detection and risk stratification of PCa in a racially diverse group of men who presented with atypical small acinar proliferation (ASAP) on initial prostate biopsy. Methods: Upon receiving IRB approval, a retrospective analysis was performed on men from the Southeast Louisiana Veterans Health Care System and Tulane University Medical Center who presented with ASAP on initial prostate biopsy and subsequently received confirmatory prostate biopsies from September 2000 through July 2015. Confirmatory biopsy with a greater than 3-year interval from the initial were excluded. Self-identified race, age, body mass index (BMI), transrectal ultrasound (TRUS) volume, serum prostate-specific antigen (PSA), PSA velocity (PSAV), PSA density (PSAD), and elapsed time between biopsies were evaluated to determine if they were predictors of subsequent PCa diagnosis in patients with an initial finding of ASAP. Results: Of the 106 men in the analysis cohort, 75 (71%) were AA and 31 (29%) were not African American (non-AA). AA had higher PSA, PSAV, and PSAD (all p < 0.05). Age, BMI and TRUS volume were not statistically different between AA and non-AA. PCa was diagnosed in subsequent biopsy in 42 (40%) patients without significant racial variation; 30 (40%) AA vs 12 (39%) non-AA. Of the 42 men with PCa, 25 (24%) met Epstein pathological criteria for significant disease, although without racial variation; 18 (24%) AA vs 7 (23%) Non-AA. Only 10 (9%) men, again without racial variation, had any component of Gleason 4; 7 (9%) AA vs 3 (10%) non-AA. On multivariate analysis, increasing age, PSA and PSAD were significant predictors of cancer on repeat biopsy while race, BMI, TRUS volume and number of cores with ASAP were not. Conclusions: AA diagnosed with ASAP on initial prostate biopsy do not have increased risk of PCa on confirmatory biopsy compared to non-AA. Regardless of race, most cancers were low grade and lower volume, and AA with ASAP should be managed in a similar manner to non-AA with ASAP.

Practice Patterns of Clinicians Following Isolated Diagnoses of Atypical Small Acinar Proliferation on Prostate Biopsy Specimens

2004 ◽  
Vol 128 (5) ◽  
pp. 557-560 ◽  
Author(s):  
Oluwole Fadare ◽  
Sa Wang ◽  
M. Rajan Mariappan
Keyword(s):  
Prostate Biopsy ◽  
Practice Patterns ◽  
Specific Antigen ◽  
Intraepithelial Neoplasia ◽  
High Rate ◽  
Pathology Report ◽  
Atypical Small Acinar Proliferation ◽  
Prostate Biopsies ◽  
Diagnostic Threshold ◽  
The Mean

Abstract Context.—The controversial diagnostic term atypical small acinar proliferation (ASAP) has gained some acceptance as a legitimate way for pathologists to describe minute foci of small prostatic acini that raise the suspicion of carcinoma but that fail to attain the requisite diagnostic threshold for carcinoma. Objective.—To investigate the practice patterns of clinicians following this diagnosis and to identify clinicopathologic parameters that may be of influence. Design.—All cases with a diagnosis of ASAP on a prostate biopsy specimen during a 7-year period were retrieved from our computerized database. Cases with concurrent diagnoses of adenocarcinoma and/or prostatic intraepithelial neoplasia were excluded. Medical and pathologic records for the remaining patients were reviewed and correlated with pathologic data. Results.—Fifty-five (2.8%) of 1964 prostate biopsies performed during this period provided the diagnosis of ASAP, of which 36 met our study criteria. The average age of the patients was 65 years, and the mean total prostate-specific antigen (PSA) level was 6.41 ng/mL. The rate of biopsy subsequent to an ASAP diagnosis was 67% (24/36), and the mean duration to subsequent biopsy was 246 days (median, 182 days; range, 71–728 days). Adenocarcinoma was diagnosed in 9 (38%) of 24 specimens taken during the subsequent biopsy. Neither age nor PSA level significantly predicted a greater likelihood for subsequent biopsy. Additionally, among patients who received a subsequent biopsy, the aforementioned parameters were not predictive of carcinoma in the second biopsy. The average number of cores following an ASAP diagnosis (6 cores) did not differ significantly from the average at initial biopsy (7.18 cores, P = .64). Pathology report characteristics, such as inclusion of a descriptive note or explicit recommendation of a second biopsy, did not significantly increase the likelihood of a subsequent biopsy. Reasons for a delay in or lack of a subsequent biopsy following an ASAP diagnosis were miscellaneous and attributable to the patients in most cases. Conclusion.—The diagnosis of ASAP generates a subsequent biopsy in two thirds of cases after an average duration of 246 days. Although closer follow-up may be recommended based on the high rate of association with carcinoma on subsequent biopsy, we found no evidence that any delays in or lack of a subsequent biopsy is attributable to a lack of understanding on the part of urologists of the significance of the diagnosis.

Racial variation in the reliability of prostate cancer indicators in men undergoing subsequent prostate biopsy.

2017 ◽  
Vol 35 (6_suppl) ◽  
pp. 115-115
Author(s):  
Robert Scott Libby ◽  
Hoang MT Nguyen ◽  
Jordan J. Kramer ◽  
Allison H. Feibus ◽  
Raju Thomas ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Prostate Biopsy ◽  
Health Care Services ◽  
African American Men ◽  
Medical Center ◽  
Specific Antigen ◽  
Transrectal Ultrasound ◽  
Veterans Health ◽  
Psa Testing ◽  
Incidence And Mortality

115 Background: Many men with an initial negative prostate biopsy have a persistently elevated prostate specific antigen (PSA) prompting physicians to perform repeat biopsies. African American men (AA) are at particular risk as they have a greater prostate cancer (PCa) incidence and mortality, yet traditional PSA testing may be less reliable in this cohort. We sought to determine the predictors of PCa and PCa severity in a racially diverse population on subsequent biopsy following an initial benign biopsy. Methods: Upon receiving Institutional Review Board approval, a retrospective analysis was performed on men with repeat prostate biopsies at Tulane Medical Center and Southeast Louisiana Veterans Health Care Services in New Orleans, Louisiana from 2003-2015. Inclusion criteria included patients with a benign initial prostate biopsy and underwent subsequent repeat prostate biopsy within 5 years. Race, age, serum PSA, PSA density (PSAD), and prostate volume by transrectal ultrasound (TRUS) were evaluated to determine if they correlate with the presence and severity of PCa. Aggressive PCa was defined as Gleason score >6. Results: A total of 209 men were included; 127 (61%) were AA, and 82 (39%) were Caucasian American men (CA). The two groups were similar with respect to PSA, PSAD, and TRUS. More AA (25.2% vs. 17.1%) had a repeat biopsy showing any PCa. Of those with PCa, 28.1% of AA and 28.6% of CA had aggressive PCa. PSAD positively correlated with any PCa (p=.015). TRUS negatively correlated with any PCa (p=.008). PSA levels (p<.001) and PSAD (p<.001) positively correlated with aggressive PCa in CA but not in AA. Conclusions: The goal of prostate biopsy particularly for those with a prior negative biopsy is to detect aggressive PCa. PSA and PSAD positively correlated with finding any PCa in both AA and CA but not with aggressive PCa in AA. PSA and PSAD are less accurate predictors of aggressive PCa in AA, and novel biomarkers are needed. [Table: see text]

scholarly journals Predictors of Gleason score upgrading in patients with prostate biopsy Gleason score ≤6

2014 ◽  
Vol 8 (5-6) ◽  
pp. 342 ◽  
Author(s):  
Hasmet Sarici ◽  
Onur Telli ◽  
Orhan Yigitbasi ◽  
Musa Ekici ◽  
Berat Cem Ozgur ◽  
...  
Keyword(s):  
Gleason Score ◽  
Prostate Biopsy ◽  
Prostate Volume ◽  
Specific Antigen ◽  
Transrectal Ultrasound ◽  
Radical Retropubic Prostatectomy ◽  
Small Sample ◽  
Ultrasound Guided ◽  
Increased Risk ◽  
Biopsy Gleason Score

Introduction: The discrepancy between prostate biopsy and prostatectomy Gleason scores is common. We investigate the predictive value of prostate biopsy features for predicting Gleason score (GS) upgrading in patients with biopsy Gleason scores ≤6 who underwent radical retropubic prostatectomy (RRP). Our aim was to determine predictors of GS upgrading and to offer guidance to clinicians in determining the therapeutic option.Methods: We performed a retrospective study of patients who underwent RRP for clinically localized prostate cancer at 2 major centres between January 2007 and March 2013. All patients with either abnormal digital examination or elevated prostate-specific antigen at screening underwent transrectal ultrasound-guided prostate biopsy. Variables were evaluated among the patients with and without GS upgrading. Our study limitations include its retrospective design, the fact that all subjects were Turkish and the fact that we had a small sample size.Results: In total, 321 men had GS ≤6 on prostate biopsy. Of these, 190 (59.2%) had GS ≤6 concordance and 131 (40.8%) had GS upgrading from ≤6 on biopsy to 7 or higher at the time of the prostatectomy. Independent predictors of pathological upgrading were prostate volume <40 cc (p < 0.001), maximum percent of cancer in any core (p = 0.011), and >1 core positive for cancer (p < 0.001).Conclusions: When obtaining an extended-core biopsy scheme, patients with small prostates (≤40 cc), greater than 1 core positive for cancer, and an increased burden of cancer are associated with increased risk of GS upgrading. Patients with GS ≤6 on biopsy with these pathological parameters should be carefully counselled on treatment decisions.

Prostate-Specific Antigen Increase during Dutasteride to Indicate the Need for Prostate Biopsy: Influence of Prostatic Inflammation

2017 ◽  
Vol 84 (3) ◽  
pp. 158-164 ◽  
Author(s):  
Alessandro Sciarra ◽  
Martina Maggi ◽  
Andrea Fasulo ◽  
Stefano Salciccia ◽  
Vincenzo Gentile ◽  
...  
Keyword(s):  
Prostate Specific Antigen ◽  
Prostate Biopsy ◽  
Specific Antigen ◽  
Serum Levels ◽  
Prostate Biopsies ◽  
Total Prostate Specific Antigen ◽  
Group A ◽  
Inflammatory Infiltrates ◽  
Prostatic Inflammation

Introduction The aim of this study was to analyze the significance of an increase in total prostate-specific antigen (PSA) serum levels despite dutasteride treatment as a predictor of prostate cancer (PC) at biopsy. We focused our attention on the rate of the first PSA increase and on the influence of prostatic inflammation. Methods From 2011 to 2016, 365 men with a previous negative prostate biopsy and persistent elevated PSA levels received dutasteride treatment. The population was followed for a range of 12-48 months. Results One hundred twelve cases with a confirmed PSA increase >0.5 ng/ml over the nadir value during the follow-up were included in Group A and underwent a new prostate biopsy. In Group A, the PSA increase was associated with PC at the re-biopsy in 66% of cases. The percentage of PSA reduction after 6 months of treatment was not a significant indicator of the risk for PC. The distribution of inflammatory infiltrates significantly (p<00.01) varied from positive to negative prostate biopsies. The relative risk for PC at biopsy significantly increased according to PSA level during dutasteride. Conclusions Treatment with dutasteride can help to analyze PSA kinetic. A persistent prostatic inflammation is a factor able to reduce the performance of PSA kinetic during dutasteride treatment.

Serum proPSA as a marker for reducing repeated prostate biopsy numbers

2017 ◽  
Vol 42 (1) ◽  
Author(s):  
Sema Nur Ayyıldız ◽  
Tevfik Noyan ◽  
Ali Ayyıldız ◽  
Erdal Benli ◽  
Abdullah Çırakoğlu ◽  
...  
Keyword(s):  
Prostate Specific Antigen ◽  
Prostate Biopsy ◽  
Prostate Volume ◽  
Specific Antigen ◽  
Lower Sensitivity ◽  
Health Index ◽  
Prostate Biopsies ◽  
Prostate Health Index ◽  
Total Psa ◽  
Prostate Health

AbstractIntroduction:Prostate specific antigen (PSA) has a lower sensitivity and specifity range of 4–10 ng/mL. We aimed to investigate the effectiveness of pPSA in reducing number of prostate biopsies.Methods:This study enrolled 80 patients aged 50 years or older whom had serum total PSA levels between 4 ng/dL and 10 ng/dL. Age, prostate volume, tPSA, fPSA, pPSA, PSA%, pPSA%, t/pPSA, f/pPSA, p/fPSA, p/tPSA, f/p/tPSA, p/f/tPSA, PSAD, fPSA/PSAD, pPSA/PSAD, (Prostate Health Index) PHI, (t/f/pPSA)/tPSA, and PHI2 (New Prostate Health Index) biopsy results were compared between subjects BPH and PCa.Results:Out of 80 subjects, 23 (29%) had PCa and 57 (71%) had BPH. Prostate volume was 51.65 mL in PCa and 64.85 mL in non-PCa group (p>0.05). The rate of PCa increased as prostate volume was reduced and age increased. fPSA, PSA%, p/f/tPSA, fPSA/PSAD values were significant in favor of respectively; BPH, BPH, PCa and BPH (p<0.05).Discussion:Using prostate health index (PHI) was beneficial for predicting PCa. In addition, using pPSA in formulas such as (PHI2) pPSA/(fPSA*√tPSA), p/f/tPSA, (t/f/pPSA)/tPSA may also be useful. This study suggests that the use of pPSA may have a role in reducing the number of prostate biopsies in differentiating PCa and BPH.

scholarly journals Vasectomy and Risk of Aggressive Prostate Cancer: A 24-Year Follow-Up Study

2014 ◽  
Vol 32 (27) ◽  
pp. 3033-3038 ◽  
Author(s):  
Mohummad Minhaj Siddiqui ◽  
Kathryn M. Wilson ◽  
Mara M. Epstein ◽  
Jennifer R. Rider ◽  
Neil E. Martin ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Cancer Treatment ◽  
Specific Antigen ◽  
Prostate Cancer Risk ◽  
The United States ◽  
Low Grade ◽  
High Grade ◽  
Follow Up Study ◽  
Increased Risk

Purpose Conflicting reports remain regarding the association between vasectomy, a common form of male contraception in the United States, and prostate cancer risk. We examined prospectively this association with extended follow-up and an emphasis on advanced and lethal disease. Patients and Methods Among 49,405 US men in the Health Professionals Follow-Up Study, age 40 to 75 years at baseline in 1986, 6,023 patients with prostate cancer were diagnosed during the follow-up to 2010, including 811 lethal cases. In total, 12,321 men (25%) had vasectomies. We used Cox proportional hazards models to estimate the relative risk (RR) and 95% CIs of total, advanced, high-grade, and lethal disease, with adjustment for a variety of possible confounders. Results Vasectomy was associated with a small increased risk of prostate cancer overall (RR, 1.10; 95% CI, 1.04 to 1.17). Risk was elevated for high-grade (Gleason score 8 to 10; RR, 1.22; 95% CI, 1.03 to 1.45) and lethal disease (death or distant metastasis; RR, 1.19; 95% CI, 1.00 to 1.43). Among a subcohort of men receiving regular prostate-specific antigen screening, the association with lethal cancer was stronger (RR, 1.56; 95% CI, 1.03 to 2.36). Vasectomy was not associated with the risk of low-grade or localized disease. Additional analyses suggested that the associations were not driven by differences in sex hormone levels, sexually transmitted infections, or cancer treatment. Conclusion Our data support the hypothesis that vasectomy is associated with a modest increased incidence of lethal prostate cancer. The results do not appear to be due to detection bias, and confounding by infections or cancer treatment is unlikely.

scholarly journals Association between HIV status and Positive Prostate Biopsy in a Study of U.S. Veterans

2009 ◽  
Vol 9 ◽  
pp. 102-108 ◽  
Author(s):  
Wayland Hsiao ◽  
Katrina Anastasia ◽  
John Hall ◽  
Michael Goodman ◽  
David Rimland ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Hiv Infection ◽  
Prostate Biopsy ◽  
Medical Center ◽  
Digital Rectal Examination ◽  
Hiv Positive ◽  
Gleason Grade ◽  
Hiv Status ◽  
Prostate Biopsies ◽  
Positive Biopsy

HIV infection is associated with increased incidence of malignancies, such as lymphomas and testicular cancers. We reviewed the relationship between HIV infection and prostate cancer in a contemporary series of prostate biopsy patients. The study is a retrospective analysis of consecutive prostate biopsies performed at a VA Medical Center. The indications for performing a prostate biopsy included an abnormal digital rectal examination and/or an elevated PSA. Patients were categorized according to their HIV status, biopsy results, and various demographic and clinical characteristics. Univariate and multivariate analyses compared distributions of HIV status, and various clinical and demographic characteristics. The adjusted measures of association between HIV status and positive biopsy were expressed as odds ratios (ORs) and corresponding 95% confidence intervals (CI). The likelihood of positive biopsy was significantly higher among 18 HIV-positive patients compared to patients with negative HIV tests (adjusted OR = 3.9; 95% CI: 1.3–11.5). In analyses restricted to prostate cancer patients, HIV-positive patients were not different from the remaining group with respect to their prostate cancer stage, PSA level, PSA velocity, PSA density, or Gleason grade. There is an association between HIV infection and prostate biopsy positive for carcinoma in a population referred for urologic workup. Further confirmation of this association by prospective studies may impact the current screening practices in HIV patients.

scholarly journals Patterns of Prostate-Specific Antigen Testing and Prostate Biopsies During the COVID-19 Pandemic

2021 ◽  
pp. 1028-1033
Author(s):  
Harvey W. Kaufman ◽  
Zhen Chen ◽  
Justin K. Niles ◽  
Jeff Radcliff ◽  
Yuri Fesko
Keyword(s):  
Prostate Cancer ◽  
Prostate Biopsy ◽  
Diagnostic Testing ◽  
Specific Antigen ◽  
International Classification Of Diseases ◽  
Prostate Biopsies ◽  
Psa Testing ◽  
Classification Of Diseases ◽  
Antigen Testing

PURPOSE This study examined changes in prostate disease screening (prostatic-specific antigen [PSA] testing), prostate biopsy testing, and prostate cancer diagnoses during the COVID-19 pandemic through December 2020. MATERIALS AND METHODS This analysis included test results from men ≥ 40 years, without prior International Classification of Diseases-10 record of prostate cancer since January 2016, who received PSA or prostate biopsy testing at Quest Diagnostics during January 2018-December 2020. Monthly trends were evaluated for three periods: prepandemic (January 2018-February 2020), early-pandemic (March-May 2020), and late-pandemic (June-December 2020). RESULTS Meeting inclusion criteria were 16,365,833 PSA and 48,819 prostate biopsy results. The average monthly number of PSA tests declined from 465,187 prepandemic to 295,786 early-pandemic (36.4% decrease; P = .01) before rebounding to 483,374 (3.9% increase; P = .23) late-pandemic. The monthly average number of PSA results ≥ 50 ng/mL (23,356; 0.14% of all PSA results) dipped from 659 prepandemic to 506 early-pandemic (23.2% decrease; P = .02) and rebounded to 674 late-pandemic (2.3% increase; P = .65). The average monthly number of prostate biopsy results decreased from 1,453 prepandemic to 903 early-pandemic (37.9% decrease; P = .01) before rebounding to 1,190 late-pandemic (18.1% decrease; P = .01). The average monthly number for Gleason score ≥ 8 (6,241; 12.8% of all prostate biopsies) declined from 182 prepandemic to 130 early-pandemic (28.6% decrease; P = .02) and decreased to 161 late-pandemic (11.5% decrease; P = .02). CONCLUSION The findings suggest that a substantial number of prostate screening opportunities and cancer diagnoses have been missed. Efforts are needed to bring such patients back for screening and diagnostic testing and to restore appropriate care for non–COVID-19–related medical conditions.

scholarly journals Importance of repeat laterally directed sextant prostate biopsy for detection of prostate cancer in high-risk patients

Medicina ◽  
2007 ◽  
Vol 43 (11) ◽  
pp. 843
Author(s):  
Kęstutis Vaičiūnas ◽  
Stasys Auškalnis ◽  
Aivaras Matjošaitis ◽  
Antanas Mickevičius ◽  
Ramūnas Mickevičius ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
High Risk ◽  
Prostate Biopsy ◽  
Specific Antigen ◽  
Antigen Level ◽  
Ultrasound Guided ◽  
High Risk Patients ◽  
Prostate Biopsies ◽  
Risk Patients ◽  
Detect Prostate Cancer

Our purpose was to evaluate the relevance of repeat laterally directed sextant prostate biopsy for detection of prostate cancer in high-risk patients. Material and methods. Our study included 195 men at high risk for prostate cancer (elevated prostatespecific antigen level and/or abnormal prostate detected by digital rectal examination). We consulted the patients in outpatient department of Kaunas University of Medicine Hospital during 2003–2007. We performed transrectal ultrasound-guided laterally directed sextant prostate biopsy in every patient. For the patients with benign histological findings and increased risk of prostate cancer, laterally directed sextant biopsies were repeated. Results. Prostate cancer was detected in 30.3% of patients (59/195) on the first prostate biopsy, in 13.1% (11/84) on the second prostate biopsy, in 10.3% (4/39) on the third, and in 7.7% (1/13) on the forth biopsy. After all biopsies, prostate cancer was detected in 38.5% (75/195) of patients, and it differed significantly from the percentage of prostate cancer cases detected on the first biopsy (30.3%, P=0.04). We detected 78.7% (59/75) of all prostate cancer cases by the first laterally directed sextant prostate biopsy. The rest 21.3% (16/75) of cases we detected by repeat biopsies. The second laterally directed sextant prostate biopsy revealed additional 14.6% (n=11) of prostate cancer cases and increased the detection of prostate cancer to 93.3% (70/75). At the time of the first prostate biopsy, prostate cancer was diagnosed most frequently when patients had both risk factors: elevated prostate-specific antigen level and abnormal digital prostate examination; prostate cancer was diagnosed in 45.3% of these patients. The odds ratio to detect prostate cancer by the first biopsy in patients with elevated prostate-specific antigen level and abnormal digital prostate examination was 3.7, and odds ratio to detect prostate cancer by repeat biopsies was 4.7. Conclusions. Repeat ultrasound-guided laterally directed sextant prostate biopsies reveal more cases of prostate cancer as compared to the first prostate biopsy. The majority of prostate cancer cases (93.3%) are detected by the first and second laterally directed sextant prostate biopsies. After the first negative prostate biopsy, we recommend to repeat prostate biopsy in high-risk patients.

Association of chronic baseline prostate inflammation with lower tumor grade in men with prostate cancer on repeat biopsy.

2016 ◽  
Vol 34 (2_suppl) ◽  
pp. 75-75
Author(s):  
Daniel M. Moreira ◽  
J. Curtis Nickel ◽  
Gerald L. Andriole ◽  
Ramiro Castro ◽  
Stephen J. Freedland
Keyword(s):  
Prostate Cancer ◽  
Chronic Inflammation ◽  
Prostate Biopsy ◽  
Acute Inflammation ◽  
Tumor Grade ◽  
Repeat Biopsy ◽  
Low Grade ◽  
High Grade ◽  
Prostate Biopsies ◽  
Prostate Inflammation

75 Background: We have previously shown that chronic baseline prostate inflammation in an otherwise benign biopsy was associated with lower risk of prostate cancer in repeat prostate biopsies and lower tumor volumes for those who are diagnosed with cancer. In the present study, we evaluated whether baseline acute or chronic prostate inflammation among men with initial negative biopsies for prostate cancer was associated with cancer grade at the 2-year repeat prostate biopsy. Methods: Retrospective analysis of 889 men 50-75 years-old with negative baseline prostate biopsy and positive 2-year repeat biopsy for prostate cancer in the REDUCE study. Acute and chronic prostate inflammation (coded as present or absent) and cancer grade were determined by central pathology. The association of inflammation in baseline biopsies with 2-year repeat biopsy cancer grade (low-grade: Gleason scores 2-6 vs. high-grade: Gleason scores 7-10) was evaluated with t test, chi-squared test and logistic regression controlling for age, race, body-mass index (BMI), digital rectal exam (DRE), prostate volume, baseline pre-study PSA and treatment (dutasteride or placebo). Results: Chronic, acute inflammation and both were detected in 533 (60%), 12 (1%) and 85 (10%) baseline biopsies, respectively. Presence of acute and chronic inflammations were significantly associated with each other (P < 0.001). Patients with chronic inflammation had significantly larger prostates (P < 0.001). Both types of inflammation were unrelated to race, BMI, PSA or DRE. At 2-year biopsy, a total of 621 (70%) tumors were low-grade and 268 (30%) tumors were high-grade. In both uni- and multivariable analyses, men with baseline chronic inflammation had significantly less high-grade tumors (univariable OR = 0.64, 95% CI = 0.47-0.87, P = 0.004; multivariable OR = 0.68, 95% CI = 0.50-0.93, P = 0.016) than those without baseline chronic inflammation. Baseline acute inflammation was not associated with tumor grade. Conclusions: Among men undergoing repeat prostate biopsy 2 years after a negative baseline biopsy who all had cancer on the follow-up biopsy, the presence baseline chronic inflammation was associated with lower prostate cancer grade.

Sign in / Sign up

Export Citation Format

Share Document