Abstract
Benign changes ranging from atrophy and inflammation to high-grade prostatic intraepithelial neoplasia (HGPIN) are common findings on prostate core needle biopsies. Although atrophy and inflammation may be precursors of prostate cancer, only HGPIN is currently recommended to be included in surgical pathology reports. To determine whether these benign findings increase prostate cancer risk, we conducted a case-control study nested within a historical cohort of 6692 men with a benign prostate specimen collected between 1990 and 2002. The analytic sample included 574 case-control pairs comprised of cases diagnosed with prostate cancer a minimum of 1 year after cohort entry and controls matched to cases on date and age at cohort entry, race, and type of specimen. The initial benign specimen was reviewed for presence of HGPIN, atrophy (simple, lobular, and partial) and inflammation (glandular and/or stromal). HGPIN significantly increased risk for prostate cancer (odds ratio (OR)2.00; 95% confidence interval (CI)1.25-3.20). Inflammation within the stromal compartment was associated with decreased risk (OR0.66; CI0.52-0.84), and diffuse stromal inflammation of severe grade had the strongest inverse association with risk (OR0.21; CI0.07-0.62). In a model adjusted for prostate-specific antigen (PSA) level at cohort entry and inflammation, simple atrophy was associated with a 33% increased prostate cancer risk that was marginally significant (P0.03). Clinicians should consider patterns and extent of inflammation when managing high-risk patients with negative biopsy results. Identifying benign inflammatory processes that underlie high PSA levels would help to reduce the number of unnecessary repeated prostate biopsies.
| Original language | English (US) |
|---|---|
| Pages (from-to) | 1023-1032 |
| Number of pages | 10 |
| Journal | Modern Pathology |
| Volume | 25 |
| Issue number | 7 |
| DOIs | |
| State | Published - Jul 2012 |
| Externally published | Yes |
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Keywords
- atrophy
- cancer risk
- prostate
- stromal inflammation
ASJC Scopus subject areas
- Pathology and Forensic Medicine
Cite this
Inflammation and preneoplastic lesions in benign prostate as risk factors for prostate cancer. / Kryvenko, Oleksandr; Jankowski, Michelle; Chitale, Dhananjay A.; Tang, Deliang; Rundle, Andrew; Trudeau, Sheri; Rybicki, Benjamin A.
In: Modern Pathology, Vol. 25, No. 7, 07.2012, p. 1023-1032.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Inflammation and preneoplastic lesions in benign prostate as risk factors for prostate cancer
AU - Kryvenko, Oleksandr
AU - Jankowski, Michelle
AU - Chitale, Dhananjay A.
AU - Tang, Deliang
AU - Rundle, Andrew
AU - Trudeau, Sheri
AU - Rybicki, Benjamin A.
PY - 2012/7
Y1 - 2012/7
N2 - Benign changes ranging from atrophy and inflammation to high-grade prostatic intraepithelial neoplasia (HGPIN) are common findings on prostate core needle biopsies. Although atrophy and inflammation may be precursors of prostate cancer, only HGPIN is currently recommended to be included in surgical pathology reports. To determine whether these benign findings increase prostate cancer risk, we conducted a case-control study nested within a historical cohort of 6692 men with a benign prostate specimen collected between 1990 and 2002. The analytic sample included 574 case-control pairs comprised of cases diagnosed with prostate cancer a minimum of 1 year after cohort entry and controls matched to cases on date and age at cohort entry, race, and type of specimen. The initial benign specimen was reviewed for presence of HGPIN, atrophy (simple, lobular, and partial) and inflammation (glandular and/or stromal). HGPIN significantly increased risk for prostate cancer (odds ratio (OR)2.00; 95% confidence interval (CI)1.25-3.20). Inflammation within the stromal compartment was associated with decreased risk (OR0.66; CI0.52-0.84), and diffuse stromal inflammation of severe grade had the strongest inverse association with risk (OR0.21; CI0.07-0.62). In a model adjusted for prostate-specific antigen (PSA) level at cohort entry and inflammation, simple atrophy was associated with a 33% increased prostate cancer risk that was marginally significant (P0.03). Clinicians should consider patterns and extent of inflammation when managing high-risk patients with negative biopsy results. Identifying benign inflammatory processes that underlie high PSA levels would help to reduce the number of unnecessary repeated prostate biopsies.
AB - Benign changes ranging from atrophy and inflammation to high-grade prostatic intraepithelial neoplasia (HGPIN) are common findings on prostate core needle biopsies. Although atrophy and inflammation may be precursors of prostate cancer, only HGPIN is currently recommended to be included in surgical pathology reports. To determine whether these benign findings increase prostate cancer risk, we conducted a case-control study nested within a historical cohort of 6692 men with a benign prostate specimen collected between 1990 and 2002. The analytic sample included 574 case-control pairs comprised of cases diagnosed with prostate cancer a minimum of 1 year after cohort entry and controls matched to cases on date and age at cohort entry, race, and type of specimen. The initial benign specimen was reviewed for presence of HGPIN, atrophy (simple, lobular, and partial) and inflammation (glandular and/or stromal). HGPIN significantly increased risk for prostate cancer (odds ratio (OR)2.00; 95% confidence interval (CI)1.25-3.20). Inflammation within the stromal compartment was associated with decreased risk (OR0.66; CI0.52-0.84), and diffuse stromal inflammation of severe grade had the strongest inverse association with risk (OR0.21; CI0.07-0.62). In a model adjusted for prostate-specific antigen (PSA) level at cohort entry and inflammation, simple atrophy was associated with a 33% increased prostate cancer risk that was marginally significant (P0.03). Clinicians should consider patterns and extent of inflammation when managing high-risk patients with negative biopsy results. Identifying benign inflammatory processes that underlie high PSA levels would help to reduce the number of unnecessary repeated prostate biopsies.
KW - atrophy
KW - cancer risk
KW - prostate
KW - stromal inflammation
UR - http://www.scopus.com/inward/record.url?scp=84863458727&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=84863458727&partnerID=8YFLogxK
U2 - 10.1038/modpathol.2012.51
DO - 10.1038/modpathol.2012.51
M3 - Article
C2 - 22460812
AN - SCOPUS:84863458727
VL - 25
SP - 1023
EP - 1032
JO - Modern Pathology
JF - Modern Pathology
SN - 0893-3952
IS - 7
ER -