Abstract
Inflammation is inherent in prostatic diseases and it is now accepted that it may facilitate cellular proliferation in both benign and malignant conditions. The strong relationship between prostatic inflammation and pathogenesis of benign prostatic hyperplasia (BPH) is supported by epidemiologic, histopathologic and molecular evidence. Contrariwise, the role of inflammation in prostate carcinogenesis is still controversial, although current data indicate that the inflammatory microenvironment can regulate prostate cancer (PCa) growth and progression. Knowledge of the complex molecular landscape associated with chronic inflammation in the context of PCa may lead to the introduction and optimization of novel targeted therapies. In this perspective, evaluation of the inflammatory component in prostate specimens could be included in routine pathology reports.
Highlights
Prostate cancer (PCa), one of the most challenging malignancies in urologic oncology, is a very inhomogeneous disease
The latest systematic review and meta-analysis on the association between prostatitis and PCa has recently been compiled by Perletti and co-workers, who reported a significant increase in the odds of prostatic adenocarcinoma in patients with a history of clinical chronic prostatitis [3]
The REduction by DUtasteride of PCa Events (REDUCE) trial demonstrated that 77.6% of all prostate biopsies exhibited inflammatory tissue and, of these, the majority (89%) had mild chronic inflammation [10]
Summary
Prostate cancer (PCa), one of the most challenging malignancies in urologic oncology, is a very inhomogeneous disease. Several authors have focused their attention on the role of inflammation in the development of PCa based on the hypothesis that inflammatory injury could prompt carcinogenesis by causing cellular stress and repeated genomic damage [3,4,5] This hypothesis has been extended from bench to bedside and numerous clinical studies have investigated the association between prostatitis and PCa without, reaching a universally accepted agreement [3]. The latest systematic review and meta-analysis on the association between prostatitis and PCa has recently been compiled by Perletti and co-workers, who reported a significant increase in the odds of prostatic adenocarcinoma in patients with a history of clinical chronic prostatitis [3] Their findings confirmed a previous meta-analysis by Jiang et al establishing a correlation between clinical prostatitis and PCa [9]. What is the role of histologically demonstrated inflammation in PCa development and progression? How can prostate inflammation be detected in everyday clinical practice?
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