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Both acute and chronic inflammation are associated with less perineural invasion in men with prostate cancer on repeat biopsy
Author(s) -
Kuang Andrew G.,
Nickel J. Curtis,
Andriole Gerald L.,
CastroSantamaria Ramiro,
Freedland Stephen J.,
Moreira Daniel M.
Publication year - 2019
Publication title -
bju international
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.773
H-Index - 148
eISSN - 1464-410X
pISSN - 1464-4096
DOI - 10.1111/bju.14428
Subject(s) - medicine , prostate cancer , inflammation , prostate , perineural invasion , prostate biopsy , dutasteride , gastroenterology , odds ratio , biopsy , confidence interval , prostate specific antigen , prostatitis , logistic regression , urology , oncology , cancer
Objectives To evaluate the association between acute and chronic inflammation with the presence of perineural invasion ( PNI ) in prostate biopsies positive for prostate cancer ( PC a). Material and Methods We conducted a retrospective analysis of 1 399 prostate biopsies positive for PC a in the Reduction by Dutasteride of PC a Events ( REDUCE ) study. PC a, 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 PC a. If confirmed, this suggests that inflammation and immunomodulation can serve as areas of potential therapeutic design to mitigate PNI in patients with PC a.