Editorial comment

摘要

Editorial Comment: These authors investigated the association of histological inflammation seen on initial screening prostate biopsy and the risk of prostate cancer on subsequent biopsy. Cases from the screening arm of the Finnish Prostate Cancer Screening Trial were used in this study. Men with biopsies in the first round of screening that were negative for prostate cancer were scored for acute and chronic inflammation. These men were then retrospectively followed throughout the course of subsequent screening intervals for a median of 10.5 years. Prostate cancer incidence was followed. The cumulative incidence of prostate cancer was 27% and 34%, respectively, in men with and without inflammation on initial biopsy. When adjusting for age, PSA, prostate volume and family history, this difference remained nonsignificant. Overall inflammation was quite common, being seen in 66% of biopsies. Acute inflammation on initial biopsy was protective against subsequent diagnosis of prostate cancer. So what is the role of inflammation in prostate cancer initiation and/or progression? This study suggests that in men with increased PSAs histological inflammation on initial biopsy is not associated with an increased risk of subsequent detection of prostate cancer during a median of 10 years. However, it is noteworthy that overall the risk of diagnosis of prostate cancer for men with an increased PSA and inflammation was 4 times greater than for men without increased PSAs.