Inflammation in biopsies may indicate lower prostate cancer risk

Signs of inflammation in a man’s prostate biopsy may indicate that he has a reduced risk of subsequently being diagnosed with prostate cancer in a future biopsy, according to the authors of a recently published study.

The study’s investigators say that because of its predictive value, inflammation should be routinely reported in prostate biopsies.

The association between inflammation and prostate cancer remains controversial. Some studies suggest that anti-inflammatory therapies reduce prostate cancer risk, while others have found that prostate inflammation is linked with a lower risk of cancer.

To investigate the issue, Daniel Moreira, MD, of the North Shore-Long Island Jewish Health System in New Hyde Park, NY, and colleagues analyzed information regarding 6,238 men aged 50 to 75 years who had PSA levels between 2.5 and 10.0 ng/mL and who had a prior negative biopsy. Patients also underwent additional biopsies 2 and 4 years later.

Acute inflammation in biopsies taken at the start of the study was most common in men of younger ages who had lower PSA levels and smaller prostates, while chronic inflammation was associated with older age and larger glands. At the 2-year biopsy, prostate cancer occurred in 900 participants (14%). Both acute and chronic inflammation was significantly associated with lower prostate cancer risk (a 25% reduced risk with acute inflammation and a 35% reduced risk with chronic inflammation), Dr. Moreira and colleagues reported in the online edition of Cancer(Dec. 9, 2013). At the 4-year biopsy, only acute inflammation was associated with a lower prostate cancer risk.

“Given its predictive value, inflammation-and its type and severity-should be routinely reported in prostate biopsies,” Dr. Moreira said. “Also, it is possible that patients with inflammation at baseline biopsy may be followed differently compared with patients without inflammation at baseline biopsy given their risk of subsequent cancer detection is lower.”

The authors noted that inflammation can arise as part of an immune response that occurs when the body recognizes malignant cells as foreign agents, thereby eliminating them before they can become an established tumor. This might help explain why inflammation was linked with lower risk of prostate cancer in the current study. If this hypothesis is true, the findings suggest that monitoring and modulating inflammation and the immune response may help in the prevention and treatment of prostate cancer.

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