Inflammation and preneoplastic lesions in benign prostate as risk factors for prostate cancer

Oleksandr Kryvenko, Michelle Jankowski, Dhananjay A. Chitale, Deliang Tang, Andrew Rundle, Sheri Trudeau, Benjamin A. Rybicki

Research output: Contribution to journalArticle

43 Citations (Scopus)

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 languageEnglish (US)
Pages (from-to)1023-1032
Number of pages10
JournalModern Pathology
Volume25
Issue number7
DOIs
StatePublished - Jul 2012
Externally publishedYes

Fingerprint

Prostate
Prostatic Neoplasms
Prostatic Intraepithelial Neoplasia
Inflammation
Atrophy
Prostate-Specific Antigen
Large-Core Needle Biopsy
Biopsy
Surgical Pathology
Case-Control Studies
Odds Ratio
Confidence Intervals

Keywords

  • atrophy
  • cancer risk
  • prostate
  • stromal inflammation

ASJC Scopus subject areas

  • Pathology and Forensic Medicine

Cite this

Kryvenko, O., Jankowski, M., Chitale, D. A., Tang, D., Rundle, A., Trudeau, S., & Rybicki, B. A. (2012). Inflammation and preneoplastic lesions in benign prostate as risk factors for prostate cancer. Modern Pathology, 25(7), 1023-1032. https://doi.org/10.1038/modpathol.2012.51

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 journalArticle

Kryvenko, O, Jankowski, M, Chitale, DA, Tang, D, Rundle, A, Trudeau, S & Rybicki, BA 2012, 'Inflammation and preneoplastic lesions in benign prostate as risk factors for prostate cancer', Modern Pathology, vol. 25, no. 7, pp. 1023-1032. https://doi.org/10.1038/modpathol.2012.51
Kryvenko, Oleksandr ; Jankowski, Michelle ; Chitale, Dhananjay A. ; Tang, Deliang ; Rundle, Andrew ; Trudeau, Sheri ; Rybicki, Benjamin A. / Inflammation and preneoplastic lesions in benign prostate as risk factors for prostate cancer. In: Modern Pathology. 2012 ; Vol. 25, No. 7. pp. 1023-1032.
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